影响食管癌根治性切除术后吻合口瘘发生的危险因素Logistic回归分析

Logistic regression analysis of risk factors for anastomotic leakage after radical resection of esophageal cancer

目的分析并探讨食管癌根治性切除术后吻合口瘘发生的危险因素,并提出预防建议。方法回顾性分析我院2016年6月至2018年3月收治的118例实施根治性切除术的食管癌患者的临床资料,统计患者吻合口瘘发生率,总结其可能的影响因素,对其危险因素分别进行单因素描述性检验和多因素Logistic回归分析。结果吻合口瘘发生率为10.17%。发生组与未发生组的性别、临床分期、病理类型、吻合方式构成比比较,差异不具有统计学意义(P>0.05)。发生组年龄>60岁、伴糖尿病、伴呼吸系统疾病、术前放疗、颈部吻合、经胸骨后吻合、手术时间>4.5h、营养不良者构成比均高于未发生组,差异具有统计学意义(P<0.05),经Logistic回归分析,以上指标均被证实为影响食管癌根治性切除术吻合口瘘发生的独立危险因素(OR=5.501、6.309、6.190、2.907、5.977、4.371、5.749、5.447,P<0.05)。结论食管癌根治性切除术吻合口瘘的风险高,年龄>60岁、伴糖尿病、伴呼吸系统疾病、术前放疗、颈部吻合、经胸骨后吻合、手术时间>4.5h、营养不良均可增加其风险。

Objective To analyze and explore the risk factors of anastomotic leakage after radical resection of esophageal cancer,and to put forward preventive suggestions.Methods The clinical data of 118 patients with esophageal cancer who underwent radical resection from June 2016 to March 2018 in our hospital were retrospectively analyzed.The incidence of patients with anastomotic leakage was counted,and the possible influencing factors were summarized.The risk factors were analyzed by univariate descriptive test and multivariate Logistic regression analysis.Results The incidence of anastomotic leakage was 10.17%.There were no significant differences in gender,clinical stage,pathological type and anastomotic pattern between the two groups(P>0.05).The proportion of patients with age>60,diabetes mellitus,respiratory diseases,preoperative radiotherapy,cervical anastomosis,retrosternal anastomosis,operation duration>4.5 hours and malnutrition in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05),and the Logistic regression analysis confirmed that the above indicators were all independent risk factors affecting the occurrence of anastomotic leakage after radical resection of esophageal cancer(OR=5.501,6.309,6.190,2.907,5.977,4.371,5.749,5.447,P<0.05).Conclusion The risk of anastomotic leakage in radical resection of esophageal cancer is high.Age>60,diabetes mellitus,respiratory diseases,preoperative radiotherapy,cervical anastomosis,post-sternal anastomosis,operation duration>4.5 hours and malnutrition can increase the risk.