高脂血症对直肠癌不同手术方式合并症的影响

Effects of Hyperlipidemia on Postoperative Complications in Patients of Rectal Cancer with Different Surgical

目的:探讨高脂血症对直肠癌不同手术方式合并症的影响。方法:回顾分析行开腹或腹腔镜直肠癌根治术治疗的255例患者的临床资料,比较伴或不伴高脂血症患者的围手术期指标,采用卡方检验或t检验进行统计学分析。结果:与非高脂血症组患者相比,高脂血症组术中出血量大(P<0.01),术后恢复进食时间长(P<0.01),术后住院时间增加(P<0.05),拔除引流管时间延长(P<0.01),切口脂肪液化并发症增多(P<0.05)。与开腹组相比,腹腔镜组术中出血量少(P<0.01),手术时间、术后恢复进食时间、术后住院时间、拔除引流管时间均明显缩短(均为P<0.01),切口脂肪液化发生率低(P<0.05)。在腹腔镜手术组,与正常血脂组相比,高脂血症患者术中出血量较大(P<0.01),余指标无明显差异。结论:高脂血症可引起直肠癌手术出血量增加、术后恢复慢、伤口脂肪液化发生率高,腹腔镜手术可加快患者术后恢复。

Objective： To investigate the effects of hyperlipidemia on postoperative complications in patients of rectal cancer with different surgical.Methods： A retrospective analysis on clinical data of 255 patients underwent open or laparoscopic rectal cancer surgical were reviewed.Perioperative indicators of patients with or without hyperlipidemia were compared.Chi-square test or t test was used for statistical analysis.Results： Compared to non-hyperlipidemic patients,hyperlipidemia group had more blood loss volume（P〈0.01）,more postoperative recovery time for eating（P〈0.01）,increased postoperative hospital stay（P〈0.05）,prolonged removal of drainage tube（P〈0.01）,increased fat liquefaction（P0.05）.Compared with laparotomy,laparoscopic group had less blood loss（P〈0.01）,operative time,postoperative recovery feeding time,postoperative hospital stay,and time to drainage tube removal were significantly reduced（all P〈0.01）,low incidence of wound fat liquefaction（P〈0.05）.In the laparoscopic surgery group,compared with normal cholesterol,higher blood loss in patients with hyperlipidemia（P〈0.01）,other indicators showed no significant difference.Conclusion： Hyperlipidemia can cause increased bleeding after rectal cancer surgery,and postoperative recovery was slow,the high incidence of wound fat liquefaction,Laparoscopic surgery can accelerate postoperative recovery.