腹腔镜直肠癌Dixon术后吻合口漏发生情况及危险因素分析及防护对策

Stoma Leakage Incidence after Laparoscopic Dixon Procedure for Rectal Cancer,and Its Risk Factors,as well as Protective Measures

目的:分析腹腔镜直肠癌Dixon术后吻合口漏发生的危险因素及防护对策。方法:回顾性分析2019-2020年我科收治的直肠癌需行腹腔镜Dixon术患者190例,对其相关资料进行收集,将出现吻合口漏患者20例设为观察组,无吻合口漏的患者170例设为对照组,并应用多因素Logistic回归分析法对吻合口漏发生的独立危险因素进行分析,并采取相应的防护对策。结果:共有20例患者在术后发生吻合口漏,发生率为10.52%。男性、存在吸烟和/或饮酒史、肿瘤大小≥5cm、吻合口距离≤5cm、手术时间≥300min,是腹腔镜直肠癌Dixon术后患者出现吻合口漏的危险因素。结论:经多因素Logistic回归分析法男性、肿瘤大小≥5cm、吻合口距离≤5cm是患者术后发生吻合口漏的独立危险因素,这为临床护理的实施提供重要依据,从而采取相应的防护对策,在减少术后吻合口漏发生的同时提高患者的生存质量。

Objective To analyse the risk factors inducing stoma leakage,and the protective measures on that. Methods Retrospectively reviewed and analysed the data of 190 cases who underwent laparoscopic Dixon procedure for rectal cancer in author’s department from 2019 to 2020 yr.,took 20 cases who had suffered from stoma leakage as observation group,rest 170 cases without stoma leakage as control group;by using multi-variate Logistic regression method analysed the independent risk factors inducing stoma leakage,as well as the adopted related protective measures. Results The incidence rate of stoma leakage was to 10.52%(20/190);male,smoking and/or drinking,neoplasms≥5 cm,distance far from ≤5 cm,and operating time≥300 min were the risk factors inducing stoma leakage in the patients underwent laparoscopic Dixon procedure for rectal cancer. Conclusion Multi-variate Logistic regression method analysis show that male,neoplasms≥5 cm,and distance far from ≤5 cm are independent risk factors which provides important basis for clinical nursing,further adopting relevant protective copy,meanwhile,reducing stoma leakage incidence should be associated with enhancing patients’ quality of life.