目的 观察肠功能的预康复措施对结直肠癌合并肠梗阻患者的疗效。 方法 选取2018年1月至2021年10月江苏省中医 院普外科收治的结直肠癌合并肠梗阻患者64例，根据接受治疗方式不同分为导管组（28例）、支架组（16例）和急诊组（20例），其中导 管组采用经肛型肠梗阻导管减压，联合早期无渣型肠内营养5～7 d后手术；支架组采用肠道支架减压，联合肠内营养、心肺功能锻炼、 并行新辅助化疗后再手术；急诊组在入院后即行手术。观察三组腹腔镜成功率、一期吻合成功率、根治比例、手术时间，术后发热率、 切口感染率，术后排气时间、术后住院天数。并比较三组术后的炎症、营养、免疫指标。 结果 首次入院时，三组患者各指标差异无统 计学意义（P>0.05）。经预康复处理后，支架组美国麻醉医师协会（ASA）分级和营养风险筛查2002（NRS 2002）评分低于急诊组（P< 0.05），导管组与急诊组差异无统计学意义（P>0.05），两组预康复前后各指标比较，ASA分级差异有统计学意义（P<0.05）。导管组和 支架组腹腔镜成功率、一期吻合成功率高于急诊组（P<0.01），三组行根治性手术的比例差异无统计学意义（P>0.05）；两组的术后发 热率、切口感染率均低于急诊组（P<0.05），支架组的手术时间短于导管组、急诊组（P<0.05）；支架组术后排气时间短于急诊组（P<0.05）； 导管组、支架组术后住院天数少于急诊组（P<0.05）。导管组、支架组的C反应蛋白、白细胞、中性粒细胞、白介素6和肿瘤坏死因子α 指标均显著低于急诊组（P<0.01）；两组的CD3+、CD4+和CD8+ T细胞计数均高于急诊组（P<0.05），CD4+ /CD8+ 三组间差异无统计学意 义（P>0.05）。结论 肠功能的预康复措施，能有效提高手术质量，改善患者的炎症、营养和免疫状况，减少感染性并发症发生率，加速 患者康复。

Objective To observe the effect of pre⁃rehabilitation of intestinal function on colorectal cancer patients with ileus. Method 64 patients with colorectal cancer complicated with intestinal obstruction admitted to Jiangsu Hospital of Traditional Chinese Medicine from January 2018 to October 2021 were selected and divided into the catheter group (28), the stent group(16) and the control group (20). The catheter group received transanal decompression combined with early enteral nutrition, and operation after 5⁃7 days. The stent group received stent decompression, combined with enteral nutrition, functional exercise, combined with chemotherapy followed by surgery. The control group received surgery immediately after admission. The rate of laparoscopy, rate of primary anastomosis, operation time, fever rate, incision infection rate, postoperative exhaust time and postoperative hospital stay were observed. The inflammatory, nutritional and immune indexes of the three groups were compared. Result At first admission, there was no significant difference in all indexes among the three groups (P>0.05). After pre⁃rehabilitation, the ASA and NRS 2002 scores of the stent group were lower than those of the control group (P<0.05), but there was no significant difference between the catheter group and the control group (P>0.05). ASA scores of the two groups were different before and after pre⁃rehabilitation (P<0.05). The success rate of laparoscopic surgery and primary anastomosis in the catheter group and the stent group was higher than that in the control group (P <0.01), but there was no significant difference in the proportion of radical surgery among the 3 groups (P>0.05). The postoperative fever rate and incision infection rate in the two groups were lower than those in the control group (P<0.05), and the operation time in the stent group was shorter than that in the other 2 groups (P<0.05). The postoperative exhaust time in stent group was significantly shorter than that in control group (P<0.05). The length of postoperative hospitalization in both groups was significantly shorter than that in control group (P<0.05). CRP, WBC, N, IL⁃6 and TNF⁃α in catheter group and stent group were significantly lower than those in control group (P<0.01). The counts of CD3+ , CD4+ and CD8+T cell in the two groups were higher than those in the control group (P <0.05), but there was no significant difference in CD4+ /CD8+ among the 3 groups (P>0.05). Conclusion Pre⁃rehabilitation of intestinal function can effectively improve the quality of surgery, reduce inflammation, improve nutritional and immune status of patients, reduce infectious complications, and speed up the recovery of patients.