食管癌术后纵隔引流管嵌入吻合口的危险因素分析  

An analysis of risk factors for mediastinal drainage tube inserting into anastomotic stoma after surgery for esophageal carcinoma

作　　者：周开国 秦华龙[1] 蒋东[1] 郑世营[1] ZHOU Kaiguo;QIN Hualong;JIANG Dong(Department of Cardiothoracic Surgery,Affiliated First Hospital,Soochow University,Suzhou 215000,CHINA)

机构地区：[1]苏州大学附属第一医院心胸外科,江苏215000

出　　处：《江苏医药》2020年第3期270-273,F0003,共5页Jiangsu Medical Journal

摘　　要：目的探讨食管癌术后纵隔引流管嵌入吻合口的危险因素。方法食管癌术后患者210例分为纵隔引流管嵌入吻合口组(嵌入组,85例)和非嵌入组(125例),采用logistic多因素回归分析影响纵隔引流管嵌入吻合口的危险因素。结果嵌入组血清白蛋白低于非嵌入组(P<0.05)。两组非手术相关因素中,上消化道胃炎、术后重症肺炎及术后呕吐比较差异有统计学意义(P<0.05);手术相关因素中,网膜未包埋和置管部位(吻合口旁)比较有统计学差异(P<0.05)。术后呕吐、低血清白蛋白及网膜未包埋是纵隔引流管嵌入吻合口的独立危险因素(P<0.05)。结论血清白蛋白低、术后呕吐、网膜未包埋是食管癌术后患者纵隔引流管嵌入吻合口而导致吻合口瘘的主要影响因素。Objective To explore the risk factors for mediastinal drainage tube inserting into anastomotic stoma after surgery for esophageal carcinoma.Methods A total of 210 patients with esophageal carcinoma underwent surgery,of whom the mediastinal drainage tube inserting into anastomotic stoma occurred in 85 cases(group A)and that did not in 125 cases(group B).The risk factors for mediastinal drainage tube inserting into anastomotic stoma after surgery were analyzed by multivariable logistic regression model analysis.Results Plasma albumin level in group A was lower than that in group B(P<0.05).There were significant differences between two groups in the non-operative factors including upper gastrointestinal gastritis,postoperative severe pneumonia and postoperative vomiting and the operative factors including unembedded omentum of covering anastomotic stoma and the tube beside the anastomotic stoma(P<0.05).Postoperative vomiting,low plasma albumin level and unembedded omentum of covering anastomotic stoma were the independent risk factors for mediastinal drainage tube inserting into anastomotic stoma(P<0.05).ConclusionLow plasma albumin level,postoperative vomiting,unembedded omentum of anastomotic stoma are the main influencing factors for mediastinal drainage tube inserting into anastomotic stoma.

关 键 词：食管癌 纵隔引流管 吻合口瘘 

分 类 号：R735[医药卫生—肿瘤]