决策结直肠癌合并急性肠梗阻个性化治疗方案的相关因素分析  

Analysis of Related Factors in Decision-making of Individualized Treat⁃ment Plan for Colorectal Cancer Complicated with Acute Intestinal Ob⁃struction

作　　者：何荣亮 郭跻 张静 HE Rongliang;GUO Ji;ZHANG Jing(General Surgery,Xiaoyi People's Hospital,Shanxi Province,Lyuliang,Shanxi Province,032300 China;Depart‐ment of General Surgery,Shanxi Bethune Hospital(Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,the Third Hospital of Shanxi Medical University),Taiyuan,Shanxi Province,030032 China;Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province,430030 China)

机构地区：[1]山西省孝义市人民医院普通外科,山西吕梁032300 [2]山西白求恩医院(山西医学科学院,同济山西医院,山西医科大学第三医院)普通外科,山西太原030032 [3]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《中外医疗》2022年第18期5-9,共5页China & Foreign Medical Treatment

基　　金：山西省应用基础研究计划项目(No.201901D211510)。

摘　　要：目的探讨影响结直肠癌合并急性肠梗阻(colorectal cancer patients with acute intestinal obstruction,CRCAIO)治疗方案决策的相关因素。方法收集2018年1月—2021年8月在山西白求恩医院及附属孝义市人民医院就诊的120例CRC-AIO患者,回顾性比较其相关临床病理资料,采用Logistic回归分析CRC-AIO治疗方案决策的影响因素。结果单因素分析显示急性完全性肠梗阻(OR=3.581,95%CI:1.174~10.918,P=0.025)及白细胞计数(OR=3.222,95%CI:1.019~10.186,P=0.046)对手术时机的选择有影响,肿瘤位置(OR=7.467,95%CI:2.084~26.754,P=0.002)及腹部手术史(OR=0.118,95%CI:0.015~0.922,P=0.042)对能否行一期切除吻合有影响。多因素分析结果显示急性完全性肠梗阻是影响患者是否需急诊手术的独立影响因素(OR=3.563,95%CI:1.143~11.105,P=0.028),肿瘤位置是预测一期切除吻合的独立因素(OR=6.891,95%CI:1.881~25.244,P=0.004)。结论急性完全性肠梗阻及肿瘤位置是决策CRC-AIO患者个性化治疗方案的重要因素。Objective To investigate the relevant factors affecting the decision-making of treatment options for colorectal cancer patients with acute intestinal obstruction(CRC-AIO).Methods A total of 120 CRC-AIO patients who were treated in Shanxi Bethune Hospital and the affiliated Xiaoyi People's Hospital from January 2018 to Au‐gust 2021 were collected.The relevant clinicopathological data were retrospectively compared,and Logistic regres‐sion was used to analyze the influencing factors of CRC-AIO treatment decision-making.Results Univariate analysis showed that acute complete intestinal obstruction(OR=3.581,95%CI:1.174-10.918,P=0.025)and white blood cell count(OR=3.222,95%CI:1.019-10.186,P=0.046)had influence on the selection of operation timing.Tumor loca‐tion(OR=7.467,95%CI:2.084-26.754,P=0.002)and history of abdominal surgery(OR=0.118,95%CI:0.015-0.922,P=0.042)had influence on whether one-stage resection and anastomosis could be performed.The results of multivariate analysis showed that acute complete intestinal obstruction was an independent factor affecting whether patients need emergency surgery(OR=3.563,95%CI:1.143-11.105,P=0.028).Tumor location was an independent factor for predicting primary resection and anastomosis(OR=6.891,95%CI:1.881-25.244,P=0.004).Conclusion Acute complete intestinal obstruction and tumor location are important factors in decision-making of personalized treatment for CRC-AIO patients.

关 键 词：结直肠癌 急性肠梗阻 个性化治疗方案 

分 类 号：R5[医药卫生—内科学]