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目的：探讨梗阻性低位直肠癌保肛治疗（直肠癌前切除术（dixon 手术））的可行性及术后肠瘘的防治。方法：回顾性分析我科 2009年1 月-2012 年1 月梗阻性低位直肠癌的保肛治疗（dixon）24 例手术患者（梗阻性保肛组）临床资料及非梗阻性低位直肠癌保肛治疗（dixon）的24 例患者（非梗阻性保肛组）临床资料，比较梗阻性与非梗阻性低位肠梗阻保肛治疗的临床疗效，分析梗阻性低位肠梗阻保肛治疗的可行性。结果：梗阻性保肛组住院天数：11.9 天，非梗阻性肠梗阻保肛组8.7 天P<0.05；梗阻性保肛组发生肠瘘：4 例（16.7%），非梗阻性肠梗阻保肛组发生肠瘘：1 例（4.2%）P<0.05，经充分引流后肠瘘愈合，无1 人死亡,两组术后至出院期间死亡人数：0 例；梗阻性保肛组肠功能恢复（以排气排便为指标）：5.1 天，非梗阻性保肛组肠功能恢复：3.8 天，P<0.05；术后 6 个月腹泻便秘患者两组相同为24 人；术后6 个月梗阻性保肛组肿瘤复发6 人（25%），非梗阻性保肛组肿瘤复发5 人（20.8%）， P>0.05。结论：梗阻性低位肠梗阻保肛治疗住院期疗效较非梗阻性保肛组差，中远期疗效无明显差异。梗阻性低位直肠癌可行保肛治疗。

英文摘要:

Objective:To explore the 64-slice volume CT digital subtraction angiography (the Volume computed tomography digital subtraction angiography, VCTDSA) combined with CT perfusion imaging in the diagnosis of acute ischemic stroke value.Methods: Retrospective analysis of 45 patients with clinically diagnosed as clinical data of patients with acute ischemic stroke, respectively to give VCTDSA and CT perfusion imaging processing, and analysis of diagnostic sensitivity and specificity of these two technologies in patients with acute ischemic stroke.Results :45 patients check intracranial bleeding lesions in different parts, more common in the ventricles, are associated with varying degrees of abnormal vascular network formation, which VCTDSA image quality is superior to CT perfusion imaging, VCTDSA than DSA can accurately display and measurement of arteriovenous fistulathe size, VCTDSA, and MRA was no significant difference in tumor long axis, the comparison of the aneurysm neck.Conclusion:The other subtraction CTA VCTDSA combined with CT perfusion imaging in the diagnosis of acute ischemic stroke patients have an advantage.

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