摘要
目的 探讨直肠癌根治术后发生吻合口瘘的危险因素及预防措施.方法 回顾性分析404例行直肠癌根治术患者的临床资料并统计分析吻合口瘘的危险因素.结果 31例(7.67%,31/404)术后发生吻合口瘘,其发生吻合口瘘的平均时间为术后6.5(3 ~ 14)d.对吻合口瘘危险因素进行多因素Logistic回归分析,发现术前血红蛋白(OR=3.023,95%CI:1.101 ~ 8.303,P=0.031 8)、肿瘤直径(OR=2.543,95% CI:1.075 ~ 6.018,P=0.033 7)、肿瘤距肛缘距离(OR=3.160,95% CI:1.387~ 7.199,P=0.0062)是发生吻合口瘘的危险因素.结论 术前血红蛋白水平、肿瘤直径及肿瘤距肛缘距离是直肠癌根治术后发生吻合口瘘的危险因素,纠正贫血,提高手术技巧,并适当选用预防性肠造瘘,有利于预防吻合口瘘的发生.
Objective To explore the risk factors and prevention measures for anastomotic leakage after rectal radical resection.Methods The clinical data of 404 patients with rectal radical resection were analyzed retrospectively and the risk factors for anastomotic leakage were analyzed.Results Thirty-one patients (7.67%,31/404) were subjected to anastomotic leakage.The mean leakage time was 6.5 (3-14) d postoperatively.The muhivariate Logistic regression analysis showed that preoperative hemoglobin (OR =3.023,95% CI:1.101-8.303,P=0.031 8),tumor size (OR =2.543,95% CI:1.075-6.018,P=0.033 7) and tumor distance from anal verge (OR =3.160,95% CI:1.387-7.199,P=0.006 2) were the risk factors for anastomotic leakage.Conclusions Preoperative hemoglobin,tumor size and tumor distance from anal verge are significant factors for anastomotic leakage.Therefore correction of anemia,improvement of surgical technique and suitable use of preventive diversion stoma ane all benefit for prevention of anastomotic leakage after rectal radical resection.
出处
《中国医师进修杂志》
2014年第26期20-22,共3页
Chinese Journal of Postgraduates of Medicine
关键词
直肠肿瘤
吻合口瘘
危险因素
Rectal neoplasms
Anastomotic leak
Risk factors