影响直肠癌术后吻合口漏的因素分析  

Analysis of the multiple factors of anastomotic leakage after rectal cancer surgery

作　　者：梁国刚 王群先[1] 韩方海[2] Liang Guogang;Wang Qunxian;Han Fanghai(Second Department of General Surgery, Qingdao Eighth People′s Hospital, Qingdao 266000, China;Department of Gastrointestinal Surgery, Sun Yixian Memorial Hospital Affiliated to Sun Yat-sen University, Guangzhou 510030, China)

机构地区：[1]青岛市第八人民医院普外二科,266000 [2]中山大学附属孙逸仙纪念医院胃肠外科,广州510030

出　　处：《中华结直肠疾病电子杂志》2019年第5期475-479,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的探讨直肠癌保肛手术后发生吻合口漏的影响因素。方法回顾性收集2015年10月~2018年10月间中山大学附属孙逸仙纪念医院和青岛市第八人民医院普外科行直肠癌保肛手术的患者216例。应用SPSS 20.0统计软件对NRS2002、吻合口距齿状线距离、肿瘤TNM分期、肿瘤最大直径、肿瘤环周度、年龄、肠梗阻等因素进行分析。结果χ^2检验显示NRS2002评分≥3分、吻合口距齿状线距离≤5 cm、肿瘤TNM分期Ⅲ期、肿瘤最大直径≥5 cm、肿瘤环周度≥3/4环、年龄≥60岁、肠梗阻等是影响吻合口漏的因素;应用Logistic回归分析显示NRS2002评分≥3分、吻合口距齿状线距离≤5 cm是影响吻合口漏的独立因素。结论吻合口距齿状线距离≤5 cm、NRS2002评分≥3分的患者,应该警惕直肠癌保肛术后吻合口漏的发生。Objective To explore the influencing factors of anastomotic leakage after anuspreserving surgery for rectal cancer. Methods It is a retrospective collection of 216 patients with rectal carcinoma of rectal cancer of the Sun Yat-sen Memorial Hospital Affiliated to Sun Yat-sen University and Qingdao Eighth People′s Hospital from October 2015 to October 2018. SPSS20.0 statistical software was used to analyze NRS2002, the distance between anastomotic and dentate line, tumor TNM periodization, maximum diameter of the tumor, circumference of the tumor, age and intestinal obstruction. Results χ^2 test showed that NRS2002 score 3 points or more, the distance between anastomotic and dentate line is 5 cm or less, tumor TNM periodization is in the Ⅲ period, tumor maximum diameter ≥ 5 cm, tumor circumference ≥ 3/4 ring, age ≥ 60 years, and intestinal obstruction are the factors that influence the anastomotic fistula. The Logistic regression analysis showed that NRS2002 score ≥ 3 points, and anastomotic dentate distance ≤ 5 cm are the independent factors affecting anastomotic leakage. Conclusion The patients, whose anastomotic dentate line distance of 5 cm or less and NRS2002 score 3 points or more should guard against the occurrence of anastomotic fistula after rectal cancer surgery.

关 键 词：直肠肿瘤 保肛手术 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]