食管癌术后吻合口瘘的危险因素研究  

Research on the risk factors of anastomotic fistula after esophageal cancer surgery

作　　者：赵云[1] 崔健[1] ZHAO Yun;CUI Jian(Department of Thoracic Surgery,Beijing Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing,100022)

机构地区：[1]清华大学附属北京市垂杨柳医院胸外科,北京100022

出　　处：《实用临床医药杂志》2024年第1期37-40,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨食管癌患者术后发生吻合口瘘的危险因素。方法回顾性分析107例食管癌手术患者的临床资料,将术后发生吻合口瘘的21例患者纳入观察组,将术后未发生吻合口瘘的86例患者纳入对照组,通过单因素分析和多因素Logistic回归分析明确食管癌术后发生吻合口瘘的危险因素。结果单因素分析结果显示,年龄、低蛋白血症、糖尿病史、术前新辅助治疗、吻合部位均与食管癌术后吻合口瘘有关(P<0.05);多因素Logistic回归分析显示,术前接受新辅助治疗是食管癌患者术后发生吻合口瘘的独立危险因素(OR=5.392,95%CI:1.335~30.382,P=0.020)。结论术前接受新辅助治疗是食管癌患者术后发生吻合口瘘的独立危险因素,对于术前合并其他系统疾病尤其是糖尿病、低蛋白血症的高危患者,应做好充分的术前准备。Objective To investigate the risk factors of anastomotic fistula after esophageal cancer surgery.Methods The clinical data of 107 patients with esophageal cancer surgery were retrospectively analyzed,among whom 21 patients with anastomotic fistula after surgery were included in observation group,and 86 patients without anastomotic fistula after surgery were included in control group.The risk factors of anastomotic fistula after esophageal cancer surgery were identified by univariate analysis and multivariate Logistic regression analysis.Results Univariate analysis showed that age,hypoproteinemia,history of diabetes,preoperative neoadjuvant therapy,and anastomotic site were associated with anastomotic fistula after esophageal cancer surgery(P<0.05);multivariate Logistic regression analysis showed that preoperative neoadjuvant therapy was an independent risk factor for postoperative anastomotic fistula in patients with esophageal cancer(OR=5.392;95%CI,1.335 to 30.382;P=0.020).Conclusion Preoperative neoadjuvant therapy is an independent risk factor for postoperative anastomotic fistula in patients with esophageal cancer.For patients with preoperative comorbid diseases,especially diabetes and hypoproteinemia,adequate preoperative preparation should be made.

关 键 词：食管癌手术 吻合口瘘 新辅助治疗 低白蛋白血症 糖尿病 危险因素 

分 类 号：R735.1[医药卫生—肿瘤] R619[医药卫生—临床医学] R730.56