导致直肠癌术后吻合口瘘相关临床因素分析

Analysis of Related Clinical Factors of Anastomotic Leakage After Resection of Rectal Cancer

目的探讨导致直肠癌术后吻合口瘘的相关临床因素。方法选择在我院实施直肠癌手术共253例,其中16例发生术后吻合口瘘。分析年龄、性别、引流管数量、术前血红蛋白水平、术前白蛋白水平、糖尿病病史、术前合并肠梗阻、肠道准备、远处转移对术后吻合口瘘发生的影响。结果年龄≥65岁患者术后吻合口瘘发生率高于年龄<65岁患者、术前白蛋白水平<40 g/L患者术后吻合口瘘发生率高于≥40g/L患者、术前合并有肠梗阻患者的术后吻合口瘘发生率高于术前无合并肠梗阻患者,差异有统计学意义(P<0.05)。结论术前白蛋白水平、术前合并肠梗阻对直肠癌术后患者发生吻合口瘘有影响,针对存在上述因素的患者可实施预防性造口,避免发生术后吻合口瘘。

Objective To explore the clinical factors of anastomotic leakage after colorectal cancer operation.Methods 253 cases of patients with rectal cancer were selected in our hospital, of which 16 patients had anastomotic leakage after operation. Analysis of age, gender, drainage tube number, preoperative hemoglobin level, preoperative albumin level, history of diabetes, preoperative with intestinal obstruction, bowel preparation, distant metastasis on postoperative anastomotic fistula occurred in the effects. ResultsThe anastomotic ifstula rate of patients of age more than or equal to 65 was higher than that of the patients aged less than 65 years old. The anastomotic fistula rate of patients with preoperative albumin level less than 40 g/L was higher than that of the patients with preoperative albumin more than or equal to 40 g/L. The anastomotic ifstula rate of patients with preoperative intestinal obstruction was higher than that of the patients with not complicated with intestinal obstruction before operation, the difference was statistically signiifcant （P〈0.05）.Conclusion The preoperative albumin level and intestinal obstruction effect the incidence of anastomotic ifstula in the patients after colorectal cancer operation. According to these factors, the defunctioning stoma is helpful to avoid postoperative anastomotic ifstula.