老年结直肠癌术后1月肠梗阻发生率及影响因素分析  

Survey of intestinal obstruction one month after radical surgery in elderly patients with colorectal cancer and analysis of the influencing factors

作　　者：王勇[1] 张卫 赵政[1] 倪平[1] 王少文[3] 

机构地区：[1]上海市江湾医院普外科,上海市200434 [2]上海长海医院结直肠外科,上海市200433 [3]白求恩国际和平医院普外科,河北省石家庄市050082

出　　处：《实用老年医学》2016年第11期919-921,共3页Practical Geriatrics

摘　　要：目的调查老年结直肠癌术后1月肠梗阻发生率,探讨术后肠梗阻发生的影响因素。方法回顾性收集339例老年结直肠癌患者临床资料,所有患者均接受根治性切除手术并经术后病理证实,术后随访1月,收集术后肠梗阻发生情况以及可能的影响因素,采用卡方检验进行单因素筛选,将可能的影响因素纳入多因素非条件Logistic回归进行分析。结果 339例老年结直肠癌患者术后1月共26例发生肠梗阻,发生率为7.67%;有术前肠梗阻、有大肠肿瘤切除史、TNM分期越高老年结直肠癌患者术后1月肠梗阻发生率显著高于无术前肠梗阻、无大肠肿瘤切除史和TNM越低的患者;腹腔镜手术后1月肠梗阻发生率显著低于开腹手术和中转开腹患者,差异均有统计学意义（P〈0.05）;多因素非条件Logistic回归分析显示,术前肠梗阻（OR=1.894,95%CI：1.019-2.664）、TNM分期（OR=5.542,95%CI：2.264-8.721）是老年结直肠癌患者术后1月肠梗阻的危险因素,而腹腔镜手术（OR=0.261,95%CI：0.013-0.563）则是其保护因素。结论老年结直肠癌术后1月肠梗阻发生率较高,对于高危人群要重点预防,并提高手术操作技术,选择合理手术入路。Objective To investigate the incidence of intestinal obstruction one month after radical surgery in elderly patients with colorectal cancer,and to explore the influencing factors. Methods The clinical data of 339 elderly patients with colorectal cancer were retrospectively collected. All patients underwent radical surgery and were confirmed by postoperative pathology. They were followed up for one month,and the incidence of intestinal obstruction was recorded. The influencing factors were assessed by chi-square test and multi-factor unconditioned Logistic regression analysis. Results Twenty-six cases out of 339 elderly patients with colorectal cancer suffered from intestinal obstruction with an incidence rate of 7. 67%. Chi-square test showed that,the patients with preoperative intestinal obstruction,history of colon tumor resection,higher TNM staging showed higher incidence rate of intestinal obstruction. While the incidence rate of intestinal obstruction in the patients receiving laparoscope was significantly lower than that in the patients receiving open operation（ P〈0. 05）. Multi-factor unconditioned Logistic regression analysis showed that preoperative intestinal obstruction（ OR=1. 894,95% CI： 1. 019-2. 664） and TNM staging（ OR = 5. 542,95% CI： 2. 264-8. 721） were risk factors for intestinal obstruction 1 month after radical surgery in elderly patients with colorectal cancer,and laparoscope（ OR = 0. 261,95%CI：0. 013-0. 563） was the protective factor. Conclusions The incidence rate of intestinal obstruction one month after radical surgery in elderly patients with colorectal cancer is high. We should focus on preventing the risk factors and improving the operation technology.

关 键 词：老年人 结直肠癌 根治性切除手术 肠梗阻 影响因素 LOGISTIC回归分析 

分 类 号：R735.3[医药卫生—肿瘤]