直肠癌前切除术后吻合口漏危险因素分析  

Risk factors for anastomotic leakage after anterior resection for rectal cancer

作　　者：潘博 周建平[1] 董明[1] PAN Bo, ZHOU Jian-ping, DONG Ming(Department of Gastrointestinal Surgery, the First Hospital of China Medical University, Shenyang 110001, China)

机构地区：[1]中国医科大学附属第一医院胃肠外科,辽宁沈阳110001

出　　处：《中国实用外科杂志》2018年第10期1174-1176,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨直肠癌前切除术后发生吻合口漏的危险因素。方法回顾性分析2014年1月至2018年6月中国医科大学附属第一医院胃肠外科行直肠癌前切除术的262例病人的临床资料,对资料中的31个变量与吻合口漏的关系进行单因素和多因素分析,以探讨发生吻合口漏的危险因素。结果行直肠癌前切除术的262例病人中有41例(15.6%)发生吻合口漏,单因素分析结果显示,远端直肠切割闭合器触发数(P=0.040)、吻合方式(P=0.030)、围手术期输血(P<0.001)、术后腹泻(P<0.001)与术后吻合口漏明显相关;多因素分析发现,吻合方式(P=0.008)、围手术期输血(P<0.001)、术后腹泻(P<0.001)是术后发生吻合口漏的独立危险因素。结论直肠癌前切除术中建议尽量减少吻合器击发次数,避免不必要的围手术期输血,并重视术后早期腹泻,有利于降低吻合口漏的发生率。Objective To explore the risk factors for anastomotic leakage after anterior resection for rectal cancer. Methods The clinical data of 262 patients who underwent anterior resection for rectal cancer in the Department of Gastrointestinal Surgery, the First Hospital to China Medical University from January 2014 to June 2018 were analyzed retrospectively. The association between the 31 variables and anastomotic leakage by univariate and multivariate logistic regression analyses were performed. Results Forty-one patients had anastomotic leakage which constituted 15.6% of total 262 patients who underwent anterior resection for rectal cancer. The results of univariate analyses revealed that ： the number of distal rectal cut closure （P=0.040） , anastomotic methods （P=0.030） , perioperative blood transfusion （P〈 0.001 ） , postoperative diarrhea （P〈0.001） were significantly associated with anastomotic leakage; Multivariate analyses found that： anastomotic methods （P=0.008） , perioperative blood transfusion （P〈0.001） , postoperative diarrhea （P〈 0.001） were significantly associated with anastomotic leakage independently. Conclusion In anterior resection of rectal cancer, reduce use frequency of anastomat stapler, avoid unnecessary perioperative blood transfusion, and pay attention to early postoperative diarrhea, it is helpful to reduce anastomotic leakage.

关 键 词：直肠癌前切除术 吻合口漏 危险因素 

分 类 号：R6[医药卫生—外科学]