结直肠癌患者腹腔镜术后动力性肠梗阻发生现状及影响因素  

Current status and influencing factors of dynamic intestinal obstruction after laparoscopic surgery in patients with colorectal cancer

作　　者：王超[1] 袁紫旭 张继业[1] 蔡建 雷彬花 Wang Chao;Yuan Zixu;Zhang Jiye;Cai Jian;Lei Binhua(Department of Gastrointestinal Surgery,Sanmenxia Central Hospital,Sanmenxia 472000,China;Department of Colorectal and Anal Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510000,China;Department of Oncology,Sanmenxia Central Hospital,Sanmenxia 472000,China)

机构地区：[1]三门峡市中心医院胃肠外科,三门峡472000 [2]中山大学附属第六医院结直肠肛门外科,广州510000 [3]三门峡市中心医院肿瘤内科,三门峡472000

出　　处：《国际医药卫生导报》2022年第16期2221-2224,共4页International Medicine and Health Guidance News

基　　金：国家自然科学基金青年科学基金项目(82103038)。

摘　　要：目的分析结直肠癌患者腹腔镜术后动力性肠梗阻发生现状及影响因素,以期为临床预防动力性肠梗阻的发生提供指导。方法回顾性分析2018年1月至2020年1月三门峡市中心医院收治的86例行腹腔镜术的结直肠癌患者临床资料,其中男52例、女34例,年龄(56.82±4.38)岁。设计基线资料研究表,阅读患者临床资料,统计患者的肿瘤部位、国际抗癌联盟联合制定分期(TNM分期)、腹腔感染、放疗等信息及动力性肠梗阻发生情况,采用logistic回归分析结直肠癌患者腹腔镜术后动力性肠梗阻发生的影响因素。计数资料采用χ^(2)检验。结果86例结直肠癌患者腹腔镜术后发生动力性肠梗阻6例,发生率为6.98%。经单因素及多因素分析结果显示,肿瘤位于直肠[17.86%(5/28)]、术前伴有肠梗阻[21.05%(4/19)]、TNM分期为Ⅲ期[15.63%(5/32)]、术后发生腹腔感染[26.67%(4/15)]、术后采用放疗[19.05%(4/21)]均为行腹腔镜术的结直肠癌患者术后发生动力性肠梗阻的危险因素(OR=12.391、8.667、9.815、12.545、7.412,均P<0.05)。结论肿瘤位于直肠、术前伴有肠梗阻、TNM分期为Ⅲ期、术后发生腹腔感染、术后采用放疗均为行腹腔镜术的结直肠癌患者术后发生动力性肠梗阻的危险因素,临床可据此采取相关干预,以降低动力性肠梗阻的发生率。Objective To analyze the current status and influencing factors of dynamic intestinal obstruction after laparoscopic surgery in patients with colorectal cancer,in order to provide guidances for clinical prevention of dynamic intestinal obstruction.Methods The clinical data of 86 patients with colorectal cancer who underwent laparoscopic surgery in Sanmenxia Central Hospital from January 2018 to January 2020 were retrospectively analyzed.There were 34 females and 52 males,aged(56.82±4.38)years.A baseline data research table was designed,and the patients'clinical data was read.The tumor location,TNM stage,abdominal infection,radiotherapy,and other information and the occurrence of dynamic intestinal obstruction in the patients were counted.Logistic regression analysis was used to analyze the influencing factors of dynamic intestinal obstruction after laparoscopic surgery in patients with colorectal cancer.The count data were tested byχ^(2) test.Results Of the 86 patients with colorectal cancer after laparoscopic surgery,dynamic intestinal obstruction occurred in 6 cases,with an incidence of 6.98%.Univariate and multivariate analysis showed that tumor located in the rectum[17.86%(5/28)],preoperative intestinal obstruction[21.05%(4/19)],TNM stageⅢ[15.63%(5/32)],postoperative abdominal infection[26.67%(4/15)],and postoperative radiotherapy[19.05%(4/21)]were all risk factors for dynamic intestinal obstruction in patients with colorectal cancer undergoing laparoscopic surgery(OR=12.391,8.667,9.815,12.545,and 7.412;all P<0.05).Conclusions Tumor located in the rectum,preoperative intestinal obstruction,TNM stageⅢ,postoperative abdominal infection,and postoperative radiotherapy are all risk factors for postoperative dynamic intestinal obstruction in patients with colorectal cancer undergoing laparoscopic surgery;clinical interventions can be taken accordingly to reduce the incidence of dynamic intestinal obstruction.

关 键 词：结直肠癌 腹腔镜 动力性肠梗阻 腹腔感染 放疗 

分 类 号：R735.34[医药卫生—肿瘤]