结直肠癌患者围手术期并发症和病死率的研究

Perioperative morbidity and mortality of patients with colorectal cancer

目的研究一家教学医院结、直肠癌患者住院期间的并发症和病死率情况。方法收集北京大学第三医院1992-2005年903例结、直肠癌患者的资料，对住院期间的并发症和病死率进行分析研究。结果903例患者中，结肠癌518例，占57．4％；直肠癌385例，占42．6％。住院期间并发症的总发生率为21．8％（197／903），结肠癌为18．3％（95／518），直肠癌为26．5％（102／385）。其中会阴部伤口感染、腹部伤口感染、肺部感染、肠梗阻较常见。吻合口漏的发生率为1．2％（8／717），在结肠癌为0．8％（4／518），直肠癌为2．0％（4／199）。2000年前、后并发症的总发生率没有明显变化。急诊手术的伤口感染、肺部感染、腹腔内感染的发生率明显高于择期手术。结、直肠癌患者住院期间病死率为1．0％。急诊手术的病死率为3．8％（3／80），择期手术为0．5％（2／438）（P=0．028）。结论2000年后新技术的引入并没有改变结、直肠癌患者住院并发症的发生率。

Objective To investigate the perioperative morbidity and mortality of patients with colorectal cancer. Methods Postoperative morbidity and mortality were analyzed in 903 colorectal cancer patients of Peking University Third Hospital from 1992 to 2005. Results There was colonic carcinoma in 518 cases （CC 57.4% ） rectal carcinoma in 385 cases （ RC 42. 6% ）. The overall perioperative morbidity rate was 21.8%, with 18.3% in CC, and 26. 5% in RC, respectively. Perineal infection, abdominal wound infection, pneumonia, and ileus were among the most often complications. The overall anastomotic leakage rate was 1.2% , with 0. 8% in CC, and 2. 0% in RC, respectively. Morbidity rate after the year 2000 was similar to that before 1999. The incidence of wound infection, pneumonia, and intra-abdominal infection were significantly higher following emergency surgery. The overall mortality rate was 1.0%. The mortality rate was significantly higher in emergency cases （3. 8% ） than that of 0. 5% in elective cases （P = 0. 028）. Conclusion Introduction of new technology after the year 2000 does not significantly decrease the incidence of morbidity in patients of colorectal carcinoma.