中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
26期
20-22
,共3页
直肠肿瘤%吻合口瘘%危险因素
直腸腫瘤%吻閤口瘺%危險因素
직장종류%문합구루%위험인소
Rectal neoplasms%Anastomotic leak%Risk factors
目的 探讨直肠癌根治术后发生吻合口瘘的危险因素及预防措施.方法 回顾性分析404例行直肠癌根治术患者的临床资料并统计分析吻合口瘘的危险因素.结果 31例(7.67％,31/404)术后发生吻合口瘘,其发生吻合口瘘的平均时间为术后6.5(3 ～ 14)d.对吻合口瘘危险因素进行多因素Logistic回归分析,发现术前血红蛋白(OR=3.023,95％CI:1.101 ～ 8.303,P=0.031 8)、肿瘤直径(OR=2.543,95％ CI:1.075 ～ 6.018,P=0.033 7)、肿瘤距肛缘距离(OR=3.160,95％ CI:1.387～ 7.199,P=0.0062)是发生吻合口瘘的危险因素.结论 术前血红蛋白水平、肿瘤直径及肿瘤距肛缘距离是直肠癌根治术后发生吻合口瘘的危险因素,纠正贫血,提高手术技巧,并适当选用预防性肠造瘘,有利于预防吻合口瘘的发生.
目的 探討直腸癌根治術後髮生吻閤口瘺的危險因素及預防措施.方法 迴顧性分析404例行直腸癌根治術患者的臨床資料併統計分析吻閤口瘺的危險因素.結果 31例(7.67％,31/404)術後髮生吻閤口瘺,其髮生吻閤口瘺的平均時間為術後6.5(3 ～ 14)d.對吻閤口瘺危險因素進行多因素Logistic迴歸分析,髮現術前血紅蛋白(OR=3.023,95％CI:1.101 ～ 8.303,P=0.031 8)、腫瘤直徑(OR=2.543,95％ CI:1.075 ～ 6.018,P=0.033 7)、腫瘤距肛緣距離(OR=3.160,95％ CI:1.387～ 7.199,P=0.0062)是髮生吻閤口瘺的危險因素.結論 術前血紅蛋白水平、腫瘤直徑及腫瘤距肛緣距離是直腸癌根治術後髮生吻閤口瘺的危險因素,糾正貧血,提高手術技巧,併適噹選用預防性腸造瘺,有利于預防吻閤口瘺的髮生.
목적 탐토직장암근치술후발생문합구루적위험인소급예방조시.방법 회고성분석404례행직장암근치술환자적림상자료병통계분석문합구루적위험인소.결과 31례(7.67％,31/404)술후발생문합구루,기발생문합구루적평균시간위술후6.5(3 ～ 14)d.대문합구루위험인소진행다인소Logistic회귀분석,발현술전혈홍단백(OR=3.023,95％CI:1.101 ～ 8.303,P=0.031 8)、종류직경(OR=2.543,95％ CI:1.075 ～ 6.018,P=0.033 7)、종류거항연거리(OR=3.160,95％ CI:1.387～ 7.199,P=0.0062)시발생문합구루적위험인소.결론 술전혈홍단백수평、종류직경급종류거항연거리시직장암근치술후발생문합구루적위험인소,규정빈혈,제고수술기교,병괄당선용예방성장조루,유리우예방문합구루적발생.
Objective To explore the risk factors and prevention measures for anastomotic leakage after rectal radical resection.Methods The clinical data of 404 patients with rectal radical resection were analyzed retrospectively and the risk factors for anastomotic leakage were analyzed.Results Thirty-one patients (7.67％,31/404) were subjected to anastomotic leakage.The mean leakage time was 6.5 (3-14) d postoperatively.The muhivariate Logistic regression analysis showed that preoperative hemoglobin (OR =3.023,95％ CI:1.101-8.303,P=0.031 8),tumor size (OR =2.543,95％ CI:1.075-6.018,P=0.033 7) and tumor distance from anal verge (OR =3.160,95％ CI:1.387-7.199,P=0.006 2) were the risk factors for anastomotic leakage.Conclusions Preoperative hemoglobin,tumor size and tumor distance from anal verge are significant factors for anastomotic leakage.Therefore correction of anemia,improvement of surgical technique and suitable use of preventive diversion stoma ane all benefit for prevention of anastomotic leakage after rectal radical resection.
