新疆地区汉族和维吾尔族肠造口病人术后短期并发症的调查及其影响因素分析

Investigation on short-term complications and influencing factors of patients with colostomy in Han and Uygur ethnic groups of Xinjiang region

目的探讨新疆地区汉族和维吾尔族肠造口病人术后短期并发症的发生率和影响因素。方法收集2016年1月至2018年1月新疆医科大学第一附属医院行肠造口术的汉族和维吾尔族病人各120例,回顾性分析两组病人术后短期(1月以内)并发症的发生率和对病人生活质量的影响,分析影响不同民族肠造口病人短期并发症的危险因素。结果新疆地区汉族和维吾尔族造口病人短期并发症的种类主要均为水肿、旁疝、感染、造口脱垂、肠梗阻、出血、皮炎、局部坏死、回缩狭窄和皮肤黏膜分离。各种并发症的发生率在两个民族之间差异无统计学意义(P>0.05),但相比汉族病人,维吾尔族病人总的并发症发生率明显增加,差异有统计学意义(χ2=4.022,P=0.045)。新疆地区汉族和维吾尔族发生造口并发症的病人生理维度、心理维度、精神维度和生活质量总分均低于未发生并发症的病人,其中维吾尔族并发症病人生活质量评分下降的更加明显,差异有统计学意义(P<0.01)。单因素和多因素logistic回归分析显示:造口师指导、Dukes分期、腹壁造口切口直径、造口类型以及合并疾病是影响汉族造口病人术后短期并发症的独立危险因素(P<0.05或P<0.01);造口师指导、Dukes分期、腹壁造口切口直径、造口类型、居住地以及合并疾病是影响维吾尔族肠造口病人术后短期并发症的独立危险因素(P<0.05或P<0.01)。结论新疆地区肠造口病人术后并发症与造口类型、腹壁造口切口直径、肿瘤的Dukes分期、造口师的指导以及病人的基础疾病密切相关,维吾尔族病人还应该关注病人的体重和居住地对造口并发症的影响。

Objective To investigate the incidence and influencing factors of postoperative short-term complications of patients with colostomy in Han and Uygur ethnic groups of Xinjiang region.Methods A total of 120 Han and Uyghur patients who underwent colostomy in the First Affiliated Hospital of Xinjiang Medical University from January 2016 to January 2018 were enrolled.The short-term(less than one month)complications and impacts on the patient’s quality of life were retrospectively analyzed,and then the risk factors affecting the short-term complications were also analyzed in different ethnic groups.Results The types of shortterm complications of patients with Han and Uygur mainly included edema,paraparesis,infection,stoma prolapse,intestinal obstruction,hemorrhage,dermatitis,local necrosis,retraction stenosis and separation of skin mucous membranes.The incidence of various complications were not significantly different between the two ethnic groups(P>0.05),but the overall complications of Uygur patients was significantly higher than that of Han patients(χ2=4.022,P=0.045).The physiologic dimension,psychological dimension,mental dimension and total quality of life of patients with complications of Han and Uygur were lower than those without complications,and the scores of life quality of Uygur patients with complications decreased more significantly than Han patients(P<0.01).In addition,univariate and multivariate logistic regression analysis showed that ostomy guide,Dukes staging,abdominal incision diameter,stoma type,and comorbidities were independent risk factors for Han patients(P<0.05 or P<0.01);Ostomy guide,Dukes staging,abdominal incision diameter,stoma type,place of residence,and comorbidities were independent risk factors for Uighur patients with(P<0.05 or P<0.01).Conclusion Postoperative complications of patients with colostomy in Xinjiang region are closely related to the type of colostomy,incision diameter of the abdominal wall,Dukes stage of the tumor,guidance of the ostomyologist,and underlying disease of the patient.Uygur patients should also pay attention to the patient’s weight and living environment.