直肠癌全系膜切除术后吻合口漏形成的危险因素分析  

Clinical analysis of risk factors of anastomotic leakage after total mesorectal excision for rectal cancer

作　　者：吴清[1] 陈海军[1] 周进[2] Wu Qing;Chen Haijun;Zhou Jin(Department of general surgery,Traditional Chinese medicine hospital of Kunshan,Jiangsu Kunshan 215300,China;Department of general surgery,The First Affiliated Hospital of Suzhou University,Jiangsu Suzhou 215006,China)

机构地区：[1]昆山市中医医院普外科,江苏昆山215300 [2]苏州大学附属第一医院普外科,江苏苏州215006

出　　处：《中华普外科手术学杂志（电子版）》2021年第1期43-45,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金(81373534)。

摘　　要：目的探讨直肠癌全系膜切除术后吻合口漏形成的相关危险因素。方法回顾性分析2017年2月至2018年7月两家医院接受直肠癌全系膜切除术治疗的358例直肠癌患者的临床资料,依据术后吻合口漏发生情况,分为吻合口漏组与无吻合口漏组,吻合口漏组有52例(14.53%)患者存在吻合口漏现象,306例为无吻合口漏组。采用SPSS24.0软件进行数据处理,各类别中患者占比等计数资料用n(%)表示,单因素分析采用χ^2检验,多因素采用Logistic回归分析,P<0.05为差异具有统计学意义。结果术后吻合口漏形成的单、多因素分析结果显示:年龄(≥60岁)、营养状况(≥3分)、吻合口距肛门距离(<5 cm)、术前贫血及术前血清白蛋白(<35 g/L)为直肠癌全系膜切除术后吻合口漏形成的独立危险因素(OR>1,P<0.05)。结论直肠癌全系膜切除术后吻合口漏形成的危险因素包括年龄(≥60岁)、营养状况(≥3分)、吻合口距肛门距离(<5 cm)、术前贫血及术前血清白蛋白(<35g/L)等,可对患者术后的恢复状况造成不良影响,显著提高了患者发生吻合口漏发生率,不利于患者术后病情恢复。Objective To investigate the risk factors of anastomotic leakage after total mesorectal excision for rectal cancer.Methods From February 2017 to July 2018,clinical data of 358 rectal cancer patients with total mesorectal excision in two hospitals were retrospectively analyzed.Patients were divided into an anastomotic leakage group(52 cases,14.53%)and a non-anastomotic leakage group(306 cases)according to postoperative anastomotic leakage whether or not.Data analysis were performed by using SPSS24.0 software.The count data such as the proportion of patients in each category were represented by n(%).The univariate analysis were performed by usingχ^2 test,while multivariate analysis by using Logistic regression.A P value of<0.05 was considered as statistically significant difference.Results The results of univariate and multivariate analysis analysis of the risk factors of postoperative anastomotic leakage showed that:age(≥60 years old),nutritional status(≥3 points),distance of anastomosis to anus(<5 cm),preoperative anemia and preoperative serum albumin(<35g/L)were independent risk factors of anastomotic leakage after total mesorectal excision for rectal cancer(OR>1,P<0.05).Conclusion The risk factors of anastomotic leakage after total mesorectal excision for rectal cancer include age(≥60 years old),nutritional status(≥3 points),distance of anastomosis to anus(<5 cm),preoperative anemia and preoperative serum albumin(<35 g/L),etc.,which could adversely affect postoperative recovery and increase the incidence of anastomotic leakage,with delayed postoperative recovery of patients.

关 键 词：直肠肿瘤 全系膜切除术 吻合口漏 

分 类 号：R73[医药卫生—肿瘤]