直肠癌Dixon术中高位结扎肠系膜下动脉术后吻合口瘘的发生因素  

Risk Factors for Anastomotic Leakage after High Ligation of Mesentery in Dixon Operation for Rectal Cancer

作　　者：王学军 周志明 艾武 WANG Xuejun;ZHOU Zhiming;AI Wu(Kashi Second People's Hospital,Kashi,844000)

机构地区：[1]喀什地区第二人民医院

出　　处：《实用癌症杂志》2019年第8期1304-1308,共5页The Practical Journal of Cancer

基　　金：新疆维吾尔自治区自然科学基金(编号:2015211C218)

摘　　要：目的调查与探讨直肠癌Dixon术中高位结扎肠系膜下动脉术后吻合口瘘的发生因素。方法采用回顾性总结研究方法,选择直肠癌患者61例作为研究对象,患者都给予直肠癌Dixon术中高位结扎肠系膜下动脉术,记录患者术后吻合口瘘发生情况,调查发生的危险因素。结果患者都顺利完成手术,术后发生吻合口瘘13例(其中轻度8例,中度4例,重度1例),发生率为21.3%。单因素分析显示性别、年龄、距肛缘距离、糖尿病、临床分期、术前白蛋白、手术时间、肿瘤大小与吻合口瘘的发生密切相关(P<0.05);多因素非条件Logistic回归分析后显示:距肛缘距离、性别、术前白蛋白、手术时间、糖尿病、临床分期是直肠癌Dixon术中高位结扎肠系膜下动脉术后吻合口瘘发生的危险因素(P<0.05)。结论直肠癌Dixon术中高位结扎肠系膜下动脉术后吻合口瘘比较常见,但是以轻度为主,距肛缘距离、性别、术前白蛋白、手术时间、糖尿病、临床分期是主要的发生危险因素。Objective To investigate and investigate the risk factors of anastomotic leakage after high ligation of mesentery in Dixon operation for rectal cancer.Methods 61 cases of rectal cancer were selected,all patients were given anastomotic leakage after high ligation of mesentery in Dixon operation,and the incidence of postoperative anastomotic fistula were recorded,and the risk factors were investigated.Results All patients were completed the operation successfully,there were 13 cases of postoperative anastomotic leakage occurred(mild in 8 cases,moderate in 4 cases,severe in 1 case),and the incidence rate was 21.3%.Single factor analysis showed that sex,age,distance from the anal margin,diabetes,clinical staging,preoperative albumin,operation time,and tumor size were closely related to the occurrence of anastomotic fistula(P<0.05).Multiple factors unconditional logistic regression analysis showed that the distance from the anal border,gender,preoperative albumin,operative time,diabetes and clinical stage were the risk factors to the occurrence of anastomotic fistula(P<0.05).Conclusion Anastomotic fistula is common in high ligation of rectal carcinoma after Dixon operation,but the are more with mild,the distance from the anal border,gender,preoperative albumin,operative time,diabetes and clinical stage are the main risk factors.

关 键 词：直肠癌 DIXON术 高位结扎 吻合口瘘 危险因素 

分 类 号：R735.3[医药卫生—肿瘤]