CAJ | 학술논문

目的：探讨影响结直肠癌患者术后非计划再手术的危险因素。方法回顾性分析2010年1月至2014年1月间新疆医科大学第一附属医院胃肠外科结直肠癌根治术后近期（首次手术后3周内）接受非计划再手术的60例患者（非计划再手术组）的临床病理资料，按1∶2随机配对同期结直肠癌根治术后未再次手术的120例患者（未再手术组）进行病例对照研究。对非计划再手术的危险因素进行单因素和多因素Logistic回归分析。结果单因素分析结果显示，腹腔镜手术和手术量多的术者为非计划再手术可能的保护因素；而术中出血多、男性、高体质量指数、肿瘤分期晚合并高血压病及糖尿病为非计划再手术可能的危险因素（均P＜0．05）。对上述指标进行多因素Logistic回归分析，结果显示，术中出血多（OR＝12．935；95％ CI：2．267～73．806；P＝0．004）、术前合并糖尿病（OR＝1．747；95％ CI：1．098～2．777；P＝0．018）和男性患者（OR＝1．805；95％ CI：1．074～3．034；P＝0．026）为非计划再次手术的独立危险因素。结论对于术中出血量多、合并糖尿病以及男性的结直肠癌患者，要注意防范术后近期非计划再手术的风险。
목적：탐토영향결직장암환자술후비계화재수술적위험인소。방법회고성분석2010년1월지2014년1월간신강의과대학제일부속의원위장외과결직장암근치술후근기（수차수술후3주내）접수비계화재수술적60례환자（비계화재수술조）적림상병리자료，안1∶2수궤배대동기결직장암근치술후미재차수술적120례환자（미재수술조）진행병례대조연구。대비계화재수술적위험인소진행단인소화다인소Logistic회귀분석。결과단인소분석결과현시，복강경수술화수술량다적술자위비계화재수술가능적보호인소；이술중출혈다、남성、고체질량지수、종류분기만합병고혈압병급당뇨병위비계화재수술가능적위험인소（균P＜0．05）。대상술지표진행다인소Logistic회귀분석，결과현시，술중출혈다（OR＝12．935；95％ CI：2．267～73．806；P＝0．004）、술전합병당뇨병（OR＝1．747；95％ CI：1．098～2．777；P＝0．018）화남성환자（OR＝1．805；95％ CI：1．074～3．034；P＝0．026）위비계화재차수술적독립위험인소。결론대우술중출혈량다、합병당뇨병이급남성적결직장암환자，요주의방범술후근기비계화재수술적풍험。
Objective To explore the risk factors of unplanned reoperation after radical resection for colorectal cancer. Methods A retrospective analysis of 60 patients (within 14 to 24 days after the initial surgery) receiving unplanned reoperation after colorectal cancer surgery in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2014 was carried out , comparing with 120 randomly paired patients without reoperation during the same period. Univariate and multivariate Logistic regression analysis was performed to investigate the clinicopathologic characteristics of patients in both groups. Results Univariate logistic regression analysis showed that male, massive blood loss, diabetes, high BMI, hypertension and poorer tumor staging were selected as possible risk factors, and surgeon and laparoscopic surgery as conservative factors (all P<0.05). Multivariate logistic regression analysis revealed that massive blood loss (OR=12.935, 95% CI:2.267 to 73.806, P=0.004), diabetes (OR=1.747, 95% CI:1.098 to 2.777, P=0.018) and male (OR=1.805, 95% CI: 1.074 to 3.034, P=0.026) were the independent risk factors of unplanned reoperation after radical resection for colorectal cancer. Conclusion For heavy bleeding, diabetes and male gender in patients with colorectal cancer, surgeon should pay attention to prevent the risk of postoperative unplanned reoperation.