结直肠癌手术预后的因素及不同麻醉方法与术后生存率的关系分析  

Relationship analysis of prognostic factors in colorectal cancer surgery and different methods of anesthesia and postoperative survival

作　　者：王伟一[1] 李娟[1] 王强[1] 

机构地区：[1]河南省永城市人民医院外二科,河南永城476600

出　　处：《中国现代医生》2015年第10期90-92,共3页China Modern Doctor

摘　　要：目的：探讨结直肠癌手术的预后因素及不同麻醉方法与术后生存率的关系。方法回顾性分析2000年9月~2010年9月期间于我院接受结直肠癌手术治疗的522例患者的病历资料，其中完整随访共450例，对影响患者预后的因素统计分析，对不同麻醉方法的生存率进行比较分析。结果 T分期、淋巴结转移、原发肿瘤大小、病理分化程度、采用麻醉的方式、手术方法、手术后化疗、复发情况、远处转移情况及术后的并发症可能成为影响患者生存率的独立危险因素。在影响三组患者预后的风险系数方面，G组、EG组明显优于E组，分别为0.626（95%CI 0.372~0.863，P=0.008）与0.539（95%CI 0.463~0.774，P=0.012）。结论 T分期、淋巴结转移、原发肿瘤大小、病理分化程度、采用麻醉的方式、手术方法、手术后化疗、复发情况、远处转移情况及术后并发症与手术联系密切。硬膜外麻醉或硬膜外麻醉复合全身麻醉更适合结直肠癌手术治疗。Objective To investigate the relationship of prognostic factors in colorectal cancer surgery and different methods of anesthesia and postoperative survival. Methods A total of 522 cases of patient medical records of acceptance colorec tal cancer surgery were retrospective analysis from my hospital during the period from September 2000 to September 2010,450 cases of all were followed-up,factors affecting to the prognosis of patients were statistical Anal-ysis, and survival of different anesthesia methods were compared and analyzed. Results T stage, lymph node metasta-sis, tumor size, histological differentiation, by way of anesthesia, surgical techniques, chemotherapy,recurrence after surgery, distant metastasis and postoperative complications could be an independent risk factor for patient survival. In aspects of risk factors affecting the prognosis of patients in three groups,group G,group EG was significantly better than the group E,were 0.626（95%CI 0.372-0.863,P=0.008） and 0.539 （95%CI 0.463-0.774,P=0.012）. Conclusion T stage, lymph node metastasis,tumor size,histological differentiation, by way of anesthesia, surgical techniques,chemotherapy,recurrence after surgery, distant metastasis and postoperative complications had close contact with the surgery, epidural anesthesia or epidural anesthesia combined with general anesthesia more appropriate surgical treat-ment of colorectal cancer.

关 键 词：结直肠癌 预后因素 麻醉方法 生存率 关系分析 

分 类 号：R614[医药卫生—麻醉学]