结直肠癌根治术后肠梗阻的发生和危险因素分析  

Analysis of the Occurrence and Risk Factors of Intestinal Obstruction after Radical Resection of Colorectal Cancer

作　　者：任彩琴[1] 李静[1] 李娟 REN Caiqin;LI Jing;LI Juan(Yulin Second Hospital,Yulin,719000)

机构地区：[1]陕西省榆林市第二医院

出　　处：《实用癌症杂志》2019年第11期1816-1819,1823,共5页The Practical Journal of Cancer

摘　　要：目的分析结直肠癌根治术后肠梗阻的发生和危险因素。方法回顾性分析行结直肠癌根治术的386例患者临床资料,根据术后是否发生肠梗阻分为肠梗阻组和非肠梗阻组,采用单因素方差分析结直肠癌根治术后肠梗阻的相关影响因素,将筛选的可疑危险因素进行Logistic回归分析。结果在本组386例结直肠癌根治术患者中,术后发生肠梗阻32例(8.29%),其中机械性肠梗阻19例,麻痹性肠梗阻8例,炎症性肠梗阻5例。肠梗阻组与非肠梗阻组在性别、年龄、饮酒史、吸烟史、肿瘤部位、分化程度、病理类型、术中造瘘上差异均无统计学意义(P>0.05);2组在TNM分期、手术类型、手术方式、既往大肠肿瘤切除史、术前合并肠梗阻、贫血上差异均有统计学意义(P<0.05);经Logistic回归分析,Ⅲ期、既往大肠肿瘤切除史、开腹手术、右半或左半结肠切除术、术前合并肠梗阻均是结直肠癌根治术后肠梗阻的独立危险因素(P<0.05)。结论结直肠癌根治术后肠梗阻并不少见,与手术创伤密切相关,腹腔镜手术在保持术后肠道通畅和预防肠梗阻发生上具有优势。Objective To analyze the incidence and risk factors of intestinal obstruction after radical resection of colorectal cancer.Methods Retrospective analysis of clinical data of 386 patients who underwent radical resection of colorectal cancer were conducted,according to whether there was intestinal obstruction after operation,the patients were divided into intestinal obstruction group and non-intestinal obstruction group,one-way analysis of variance was used to analyze the influencing factors of intestinal obstruction after radical resection of colorectal cancer,logistic regression analysis was performed on the suspected risk factors screened.Results In this group of 386 patients with radical resection of colorectal cancer,32 cases of intestinal obstruction occurred after operation,the incidence rate was 8.29%,including 19 cases of mechanical intestinal obstruction,8 cases of paralytic intestinal obstruction,and 5 cases of inflammatory intestinal obstruction;there were no significant differences in gender,age,drinking history,smoking history,tumor location,differentiation degree,pathological type,and intraoperative ostomy between the intestinal obstruction group and the non-intestinal obstruction group(P>0.05);there were significant differences in TNM staging,type of surgery,surgical procedure,history of previous large intestine tumor resection,preoperative intestinal obstruction,and anemia between the 2 groups(P<0.05);Logistic regression analysis showed that stageⅢ,previous colorectal tumor resection,open surgery,right or left hemi-colectomy,and preoperative bowel obstruction were independent risk factors for intestinal obstruction after radical resection of colorectal cancer(P<0.05).Conclusion Intestinal obstruction after radical resection of colorectal cancer is not uncommon,and is closely related to surgical trauma,laparoscopic surgery has an advantage in maintaining postoperative intestinal smoothly and preventing intestinal obstruction.

关 键 词：结直肠肿瘤 根治术 肠梗阻 危险因素 

分 类 号：R735.3[医药卫生—肿瘤]