腹腔镜直肠癌手术后腹直肌萎缩发生危险因素分析  

Risk factors analysis of rectus atrophy in patients with rectal cancer after laparoscopic surgery

作　　者：郑云霞 方莉亚 卜亚美 ZHENG Yunxia;FANG Liya;BU Yamei(Huzhou First People's Hospital,Zhejiang 313000,China)

机构地区：[1]浙江省湖州市第一人民医院,湖州313000

出　　处：《浙江创伤外科》2025年第3期403-405,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 探讨腹腔镜直肠癌手术后腹直肌萎缩发生危险因素。方法 回顾性纳入2019年1月至2024年1月于本院接受腹腔镜手术治疗直肠癌患者共234例,根据术后是否发生腹直肌萎缩分组,采用单因素和多因素评估腹腔镜直肠癌手术后腹直肌萎缩发生独立危险因素。结果 纳入的234例患者术后发生腹直肌萎缩50例,发生率为21.37%。单因素分析结果显示,年龄、身体质量指数、术前蛋白水平、术后住院时间、术后卧床时间、预防性造口比例、术后慢性咳嗽比例、术后吻合口漏比例、术后手术区域感染比例及术后辅助化疗比例均与腹腔镜直肠癌手术后腹直肌萎缩发生有关(P<0.05)。多因素分析结果显示,年龄>65岁、术后卧床时间>4周、接受预防性造口、术后手术区域感染及术后辅助化疗均是腹腔镜直肠癌手术后腹直肌萎缩发生独立危险因素(P<0.05)。结论 直肠癌患者如年龄>65岁、术后卧床时间>4周、接受预防性造口、术后发生手术区域感染或术后接受辅助化疗则腹腔镜手术后腹直肌萎缩发生风险更高。Objective To investigate the risk factors of rectus atrophy in patients with rectal cancer after laparoscopic surgery.Methods 234 patients with rectal cancer treated by laparoscopic surgery in our hospital from January 2019 to January 2024 were retrospectively included and were grouped according to whether rectus atrophy occurred after surgery or not,and the independent risk factors of rectus atrophy after laparoscopic rectal cancer surgery were evaluated by univariate and multivariate methods.Results There were 50 cases with rectus atrophy after surgery in all234 patients for the incidence of 21.37%.The results of univariate analysis showed that age,body mass index,preoperative protein level,postoperative hospital stay,postoperative bed time,proportion of prophylactic ostomy,proportion of postoperative chronic cough,proportion of postoperative anasto-motic leakage,proportion of postoperative infection in the surgical area and proportion of postoperative adjuvant chemotherapy were related to the oc-currence of rectus abdominis atrophy after laparoscopic rectal cancer surgery(P<0.05).Multivariate analysis showed that age >65 years old,postoperative bed rest >4 weeks,prophylactic ostomy,postoperative surgical area infection and postoperative adjuvant chemotherapy were independent risk fac-tors for rectus atrophy after laparoscopic rectal cancer surgery(P<0.05).Conclusion The rectus atrophy risk after laparoscopic surgery was higher in patients with rectal cancer with >65 years of age,stayed in bed for >4 weeks after surgery,underwent prophylactic ostomy,developed surgical area infection after surgery,or received adjuvant chemotherapy after surgery.

关 键 词：腹腔镜 直肠癌 手术 肌肉萎缩 危险因素 

分 类 号：R735.3[医药卫生—肿瘤]