腹腔镜结直肠癌手术术后并发症的临床分析及预防策略  

Clinical analysis of postoperative complications and its preventive strategies of colorectal cancer after colorectal operation

作　　者：卓恩挺[1] 陈雪莲[1] 王连臣[1] 刘松平[1] 符国宏[1] 

机构地区：[1]海南省第三人民医院普通外科,三亚572000

出　　处：《山西医科大学学报》2013年第8期635-637,共3页Journal of Shanxi Medical University

摘　　要：目的对腹腔镜结直肠癌手术患者术后并发症进行分析,并针对相关并发症提出相应的预防措施。方法选择2009-04～2012-09来我院治疗的78例结直肠癌腹腔镜手术治疗的患者作为研究对象,采用logistic回归分析,筛选出术后发生并发症的独立危险因素;并针对并发症提出相应的预防措施。结果本组78例腹腔镜手术患者中,共有14例患者发生术后并发症,其中吻合口瘘5例(6.41%),切口感染3例(3.85%),肠梗阻2例(2.56%),泌尿系统感染2例(2.56%),盆腔感染1例(1.28%),气腹征1例(1.28%)。有2例患者同时出现两种并发症,分别为切口感染合并肠梗阻和吻合口瘘合并盆腔感染。logistic回归分析结果发现糖尿病、BMI和年龄是术后并发症的独立危险因素。结论腹腔镜结直肠癌手术时要严格控制血糖水平,注意围手术期的预防,术中严格遵循无菌操作,通过针对性的预防措施,可以减少并发症的发生。Objective To investigate the complications after laparoscopic surgery for rectal cancer patients,and put forward the corre- sponding preventive measures. Methods A total of 78 cases of colorectal cancer undergoing laparoscopic surgery were enrolled from April 2009 to September 2012 in our hospital. Logistic regression analysis was used to screen the independent risk factors of postopera- tive complications. Results Of 78 cases,14 cases had postoperative complications,including 5 cases（6.41% ） of anastomotic fistu- la,3 cases（3.85%） of incision infection,2 cases（2.56%） of intestinal obstruction,2 cases of urinary tract infection（2.56% ） ,one case （1.28%） of pelvic infection, and one case of pneumoperitoneum. One case had incision infection complicated with intestinal obstruc- tion, and another case had anastomotic fistula complicated with pelvic infection. Logistic regression analysis showed that diabetes, BMI and age were the independent risk factors of postoperative complications. Conclusion The blood glucose level should be strictly con- trolled in laparoscopic colorectal cancer operation, and the aseptic manipulation and the targeted preventive measures can reduce the in- cidence of complications.

关 键 词：腹腔镜 结直肠癌 并发症 防治对策 

分 类 号：R735.37[医药卫生—肿瘤]