364例食管癌根治术后并发症的危险因素分析  

The risk factors analysis of complications of 364 cases in treatment of radical esophagectomy

作　　者：王希文[1] 任开明[1] 刘海君[1] WANG Xiwen REN Kaiming LIU Haijun.(Department of Thoracic Surgery, Shengfing Hospital, China Medical University, Shenyang 110004, China)

机构地区：[1]中国医科大学附属盛京医院胸外科,沈阳110004

出　　处：《临床外科杂志》2017年第2期135-138,共4页Journal of Clinical Surgery

摘　　要：目的分析食管癌根治术后发生并发症的危险因素。方法食管癌患者364例,行二或三切口食管癌根治术,对影响术后并发症的10个因素进行单因素和多因素分析。结果364例患者中,66例在术后6个月内发生本研究范畴内的并发症。单因素分析表明,术前营养风险评分、T分期、术前合并症、手术时间、手术经验、吻合部位、吻合处外加手工加固缝合为影响因素。多因素分析显示,术前营养风险评分≥3、T分期≥3、术前合并症、手术时间≥240分钟、颈部吻合为独立的危险因素,吻合处外加手工加固缝合为保护因素。结论食管癌根治术后并发症的危险因素为术前营养风险评分≥3、T分期≥3、术前有合并症、手术时间≥240分钟、颈部吻合,保护因素为吻合处外加手工加固缝合。重视并控制这些危险因素可能会降低术后并发症的发生。Objective To study the risk factors of complications of 364 cases in treatment of rad- ical esophagectomy. Methods 364 patients underwent two or three-incision radical esophagectomy and the clinic data were retrospectively analyzed. After review of the reference, ten factors were regarded as the potential risk factors of postoperative complications, then univariate and multivariate analyses were per- formed. Results In 364 patients,66 patients had complications of this research field within postoperative 6 months. By univariate analysis, preoperative nutritional risk score,T-staging,preoperative complications, operation time,operation experience,anastomotic pesition,anastomotic extra manual suturing were deter- mined as influence factors. By multivariate analysis, preoperative nutritional risk score I〉3 ,T-staging score ≥3 ,preoperative complications,operation time ≥240 min, cervical anastomosis were determined as risk factors,anastomotic extra manual suturing was determined as a protective factor. Conclusion The risk factors of the complications after radical esophagectomy are preoperative nutritional risk score≥3 ,T-stag- ing score ≥ 3, preoperative complications, operation time ≥240 min, cervical anastomosis; and the protective factor is anastomotic extra manual suturing. Paying attention and controling these risk factors may reduce the occurrence of postoperative complications.

关 键 词：食管癌根治术 并发症 危险因素 

分 类 号：R735.1[医药卫生—肿瘤]