结直肠癌患者职业与手术难度和术后并发症的关系:基于DACCA的真实世界数据研究  

Association between occupation of patients with colorectal cancer and surgical difficulty and postoperative complications:a real-world study based on DACCA

作　　者：刘茹雯 杨可菲 景怡欣 汪晓东[1] 李立[1,3] LIU Ruwen;YANG Kefei;JING Yixin;WANG Xiaodong;LI Li(Division of Gastrointestinal Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China;Colorectal Cancer Center,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院普外科胃肠外科病房,成都610041 [2]四川大学华西临床医学院,成都610041 [3]四川大学华西医院结直肠肿瘤中心,成都610041

出　　处：《中国普外基础与临床杂志》2024年第10期1228-1235,共8页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的分析当前版本的华西肠癌数据库(Database from Colorectal Cancer,DACCA)中的结直肠癌患者的职业背景对手术难度和术后并发症的影响。方法采用2023年5月28日更新版本DACCA数据进行分析,所关注的数据项目涵盖了患者的职业、手术时长、解剖难度、骨盆狭窄程度、腹部肥胖状态、术区粘连情况、系膜异常情况、组织/脏器肥大、术区肠管质量、术后在院期间并发症、术后近期并发症和术后远期并发症,根据《中华人民共和国职业分类大典》将患者按职业不同分为专业技术人员、办事人员、服务人员、生产人员、制造人员和退休人员,比较6类职业患者的手术难度和术后并发症发生情况。结果按筛选条件从DACCA中获取5734条有效数据,职业特征性分析结果显示:不同职业患者的手术时长(H=11.609,P=0.041)、解剖难度(H=29.166,P<0.001)、骨盆狭窄程度(H=16.412,P=0.006)、腹部肥胖状态(H=44.622,P<0.001)、术区粘连情况(H=23.695,P<0.001)、系膜异常情况(χ^(2)=39.252,P=0.035)、组织/脏器肥大(χ^(2)=58.284,P<0.001)和术区肠管质量(H=21.041,P=0.001)均存在差异。术后在院期间、术后近期和术后远期阶段并发症发生情况在不同职业患者间的差异均无统计学意义(P>0.05);进一步亚组分析发现仅术后在院期间的发热(χ^(2)=10.969,P=0.041)和肠梗阻(χ^(2)=12.025,P=0.021)的发生在不同职业患者间的差异有统计学意义。结论患者的职业类型可能会影响结肠癌手术难度,而术后并发症的发生与患者职业并无关系,但术后发热和术后肠梗阻的发生可能与患者职业相关,其可能原因需要进一步分析。Objective To analyze the current version of the West China Database from Colorectal Cancer(DACCA)and explore how the occupational background of colorectal cancer patients affects the complexity of surgical difficulty and postoperative complications.Methods When using the updated version of DACCA data on May 28,2023 for analysis,the data items concerned covered occupation,operative duration,anatomical difficulty,pelvic stenosis,abdominal obesity,adhesion in surgical area,abnormal mesenteric status,tissue or organ hypertrophy,intestinal quality in surgical area,postoperative complications in hospital,short-term postoperative complications and long-term postoperative complications.According to the“Occupational Classification Code of the People’s Republic of China”,the occupations of patients were divided into professional and technical personnel,staff,service personal,production personnel,manufacturing personnel and retirees according to different occupations.The operative difficulty and postoperative complications of 6 groups were analyzed.Results According to the screening conditions,5734 valid data rows were obtained from DACCA.The results of occupation analysis showed that there were significant difference in operative duration(H=11.609,P=0.041),anatomical difficulty(H=29.166,P<0.001),pelvic stenosis(H=16.412,P=0.006),abdominal obesity(H=44.622,P<0.001),adhesion in surgical area(H=23.695,P<0.001),abnormal mesenteric status(χ^(2)=39.252,P=0.035),tissue or organ hypertrophy(χ^(2)=58.284,P<0.001)and intestinal quality in surgical area(H=21.041,P=0.001)between different groups.There were no significant differences in the occurrence of complications in hospital,near and short-term and long-term after operation among different occupations(P>0.05).Further subgroup analysis showed that only the difference of fever(χ^(2)=10.969,P=0.041)and intestinal obstruction(χ^(2)=12.025,P=0.021)were statistically significant among different occupations.Conclusion The occupation of patients may affect the difficulty of colo

关 键 词：结直肠癌 职业 手术难度 术后并发症 华西肠癌数据库 

分 类 号：R735.34[医药卫生—肿瘤]