结直肠癌术后急性肠梗阻的危险因素分析

Analysis of risk factors for acute intestinal obstruction after colorectal cancer surgery

目的:探讨结直肠癌术后急性肠梗阻的危险因素。方法:回顾性分析我院248例行择期结直肠癌根治术的结直肠癌患者临床资料,根据术后1个月内是否发生急性肠梗阻分为急性肠梗阻组和非急性肠梗阻组,对两组相关因素进行单因素和多因素Logistic回归分析。结果:248例行择期结直肠癌根治术的结直肠癌患者中,35例(14.11%)发生急性肠梗阻(急性肠梗阻组),213例(85.89%)未发生急性肠梗阻(非急性肠梗阻组)。两组性别、肿瘤直径、胃肠手术史、手术方法、手术时间比较,差异无统计学意义(P>0.05);急性肠梗阻组年龄>60岁、肿瘤分期偏高、开腹手术发生率均高于非急性肠梗阻组(P<0.05),而术后生长抑素使用率低于非急性肠梗阻组(P<0.05);其中年龄>60岁、肿瘤分期偏高、开腹手术为影响结直肠癌根治术后急性肠梗阻发生的独立危险因素(OR=3.564、3.149、2.895,P<0.05),而术后使用生长抑素为影响结直肠癌根治术后急性肠梗阻发生的独立保护因素(OR=0.271,P<0.05)。结论:对年龄>60岁、肿瘤分期偏高、开腹手术治疗等术后急性肠梗阻高危的结直肠癌患者,应在术后予以生长抑素等防治措施,以减少急性肠梗阻等并发症发生,促进患者术后康复。

Objective:To explore the risk factors for acute intestinal obstruction after colorectal cancer surgery.Methods:The clinical data of 248 cases of patients with colorectal cancer who were treated with radical resection of colorectal cancer were analyzed retrospectively.According to whether acute intestinal obstruction occurred within 1 month after operation,the patients were divided into acute intestinal obstruction group and non-acute intestinal obstruction group.The related factors of the two groups were analyzed by univariate and multivariate Logistic regression analysis.Results:Of the 248 patients with radical resection of colorectal cancer,35 cases(14.11%) had acute intestinal obstruction(acute intestinal obstruction group),and 213 cases(85.89%) had no acute intestinal obstruction(non-acute intestinal obstruction group).There was no significant difference in gender,tumor diameter,history of gastrointestinal surgery,surgical methods and operative time between the two groups(P>0.05).The proportions of age>60 years old,high tumor stage and incidence rate of open surgery in acute intestinal obstruction group were higher than those in non-acute intestinal obstruction group(P<0.05) while the use rate of postoperative somatostatin was lower than that in non-acute intestinal obstruction group(P<0.05).The age>60 years old,high tumor stage and open surgery were independent risk factors for acute intestinal obstruction after radical resection of colorectal cancer(OR=3.564,3.149,2.895,P<0.05),and the postoperative use of somatostatin was an independent protective factor for acute intestinal obstruction after radical resection of colorectal cancer(OR=0.271,P<0.05).Conclusion:For patients with colorectal cancer who are with age>60 years old,high tumor stage and open surgery,somatostatin and other control measures should be taken after operation to reduce the occurrence of complications such as acute intestinal obstruction and to promote the postoperative recovery.