CAJ | 학술논문

目的：探讨直肠癌保肛术后吻合口漏发生的影响因素。方法对312例患者行直肠癌保肛术，必要的情况下行预防性肠造口。观察记录患者性别、年龄、BMI、ASA评分、糖尿病、术前血红蛋白、术前血清白蛋白、肿瘤位置、肿瘤与肛缘距离、新辅助化疗、肿瘤组织类型、T分期、病理分期、手术方式、预防性肠造口等情况。结果患者年龄、术前血清白蛋白浓度、肿瘤与肛缘距离、新辅助化疗史是影响吻合口漏发生的因素，差异具有统计学意义（P＜0．05）。性别、BMI、ASA评分、糖尿病史、术前血红蛋白浓度、肿瘤位置、肿瘤组织类型、T分期、病理分期、手术方式、预防性肠造口与吻合口漏发生无关（P＞0．05）。结论患者年龄、术前血清白蛋白浓度、肿瘤与肛缘距离、新辅助化疗史是影响吻合口漏发生的因素，临床需根据实际情况，充分考虑影响因素，确保手术顺利实施。
목적：탐토직장암보항술후문합구루발생적영향인소。방법대312례환자행직장암보항술，필요적정황하행예방성장조구。관찰기록환자성별、년령、BMI、ASA평분、당뇨병、술전혈홍단백、술전혈청백단백、종류위치、종류여항연거리、신보조화료、종류조직류형、T분기、병리분기、수술방식、예방성장조구등정황。결과환자년령、술전혈청백단백농도、종류여항연거리、신보조화료사시영향문합구루발생적인소，차이구유통계학의의（P＜0．05）。성별、BMI、ASA평분、당뇨병사、술전혈홍단백농도、종류위치、종류조직류형、T분기、병리분기、수술방식、예방성장조구여문합구루발생무관（P＞0．05）。결론환자년령、술전혈청백단백농도、종류여항연거리、신보조화료사시영향문합구루발생적인소，림상수근거실제정황，충분고필영향인소，학보수술순리실시。
Objective To explore the factors affecting anastomotic leakage of rectal cancer after anuspreserving opera -tion.Methods 312 cases of patients with colorectal surgery were researched .The preparatory work were finished ,after general anesthesia,the operation were implemented according to the principles of surgery .The sex,age,BMI,the scores of ASA,diabetes, preoperative hemoglobin ,preoperative serum albumin ,tumor location,tumor and anal edge distance ,neoadjuvant chemotherapy , tumor tissue types,T stage,pathological stage,surgery,preventive colostomy were analyzed .Results There were significant differ-ences in age ,preoperative serum albumin ,tumor and anal edge distance ,neoadjuvant chemotherapy and anastomotic leakage ( P<0.05).There was no significant difference in sex ,BMI,the scores of ASA,diabetes,preoperative hemoglobin,tumor location, tumor tissue types,T stage,pathological stage,surgery,preventive colostomy and anastomotic leakage (P>0.05).Conclusion Age,preoperative serum albumin ,tumor and anal edge distance ,neoadjuvant chemotherapy are factors affecting anastomotic leak-age of rectal cancer after anuspreserving operation ,influence factors should be taken into consideration in clinical to insure the smooth implementation of surgery .