直肠癌Miles术后造瘘口旁疝形成相关危险因素的临床分析  

Clinical analysis on risk factors of the colostomy hernia after rectal cancer Miles operations

作　　者：朱德意 王婷[2] 左伟 

机构地区：[1]义乌市中医医院肛肠科,浙江金华322000 [2]义乌市中心医院肿瘤科,浙江金华322000 [3]象山第一人民医院消化科,浙江宁波315700

出　　处：《温州医学院学报》2015年第5期372-375,共4页Journal of Wenzhou Medical College

基　　金：浙江省医学会临床科研基金资助项目(2011ZYC-A66)

摘　　要：目的:探讨直肠癌Miles术后肠造瘘口旁疝形成的相关危险因素,为预防术后造瘘口旁疝的发生提供依据。方法:回顾性分析我科2005年3月-2008年3月118例行直肠癌Miles术患者的病例资料,选取可能影响造瘘口旁疝发生的14个相关因素进行单因素分析和多因素logistic回归分析,并对研究对象进行5年以上的随访。结果:118例患者中,86例术后5年发生造瘘口旁疝,发生率为72.88%。单因素分析结果显示:吸烟、体质量指数(BMI)、合并糖尿病、造口液化和/或感染、低蛋白血症、造口位置(腹膜内/外造口)的选择、术后严重腹胀、尿潴留及剧烈咳嗽与术后造瘘口旁疝的发生有关(P<0.05);进一步logistic回归分析显示:吸烟、BMI、合并糖尿病、造口液化和/或感染、造口位置(腹膜内/外造口)的选择、术后严重腹胀及剧烈咳嗽是Miles术后造瘘口旁疝发生的独立危险因素(P<0.05)。结论:直肠癌Miles术5年后肠造瘘口旁疝的发生率较高;吸烟、BMI、合并糖尿病、造口液化和/或感染、造口位置(腹膜内/外造口)的选择、术后严重腹胀及剧烈咳嗽是直肠癌Miles术术后造瘘口旁疝形成的独立危险因素。Objective： To research the risk factors related to colostomy hernia＇s occurrence after rectal cancer Miles operations and provide a basis for the prevention of occurrence of postoperative colostomy hernia. Methods： Retrospective analysis of the clinical data of the 118 patients who received rectal cancer Miles operations in our hospital from March 2005 to March 2008. The 15 possible influencing factors of the colostomy hernia were analyzed by single factor analysis and logistic regression analysis, then we conducted a 5 years＇ followup. Results： Among these 15 possible related factors of colostomy hernia＇s occurrence, smoking, body mass index（BMI）, combined diabetes, colostomy liquefaction/infection, lower proteinemia, the selection of colostomy position, severe abdominal distention, urinary retention and severe cough were related to postoperative colostomy hernia＇s occurrence（P〈0.05）. Logistic regression analysis showed that smoking, obesity, combined diabetes, colostomy liquefaction/infection, selection of colostomy position, severe abdominal distention and severe cough were significanly related with the colostomy hernia＇s as dependent risk factors（P〈0.05）. Conclusion： There is a high incidence of colostomy hernia for rectal cancer Miles operation 5 years later. Smoking, BMI, combined diabetes, colostomy liquefaction/infection, selection of colostomy position, severe abdominal distention and severe cough are significantly related with the colostomy hernia＇s as dependent risk factors.

关 键 词：直肠癌MILES术 造瘘口旁疝 危险因素 

分 类 号：R656.7[医药卫生—外科学]