腹腔镜结直肠癌根治术后动力性肠梗阻发生情况及高危因素分析

Analysis of the Incidence and High-risk Factors of Dynamic Intestinal Obstruction after Laparoscopic Radical Resection of Colorectal Cancer

目的探讨结直肠癌患者腹腔镜下根治术后动力性肠梗阻发生现状及影响因素。方法选取2020年2月-2023年4月我院收治的80例腹腔镜下结直肠癌根治术患者,根据术后是否发生动力性肠梗阻分为两组。收集患者性别、年龄、体重指数、文化程度、肿瘤位置、TNM分期、分化程度、术前是否有肠梗阻、腹部手术史、合并贫血、淋巴结转移、低蛋白血症、肿瘤直径、手术时间、吸烟酗酒史等资料。对一般资料进行单因素分析,再对有统计学差异因素的进行多因素Logistic回归分析。结果80例腹腔镜下结直肠癌根治术患者,18例动力性肠梗阻,发生率22.50%;单因素分析显示,两组TNM分期、术前是否有肠梗阻、腹部手术史、术前是否合并贫血、是否淋巴结转移、术前是否有低蛋白血症比较,差异有统计学意义(χ^(2)=18.148、7.681、8.119、10.904、9.395,P=0.000、0.003、0.006、0.0.05、0.001);Logistic回归分析TNM分期为Ⅲ期、术前有肠梗阻、有腹部手术史等是影响腹腔镜下结直肠癌根治术后动力性肠梗阻发生的独立危险因素(P<0.05且OR>1)。结论直肠癌患者腹腔镜根治术后动力性肠梗阻发生与TNM分期为Ⅲ期、术前有肠梗阻等有关,及时制定针对性预防措施,从而减少动力性肠梗阻。

Objective To explore the current situation and influencing factors of dynamic intestinal obstruction in patients with colorectal cancer after laparoscopic radical surgery.Method 80 patients who underwent laparoscopic radical resection of colorectal cancer in our hospital from February 2020 to April 2023 were selected and divided into two groups based on whether dynamic intestinal obstruction occurred after surgery.Collect data on patient gender,age,body mass index,educational level,tumor location,TNM staging,degree of differentiation,preoperative presence of intestinal obstruction,history of abdominal surgery,concomitant anemia,lymph node metastasis,hypoalbuminemia,tumor diameter,surgical time,smoking and alcohol history,etc.Perform univariate analysis on general data,and then perform multivariate logistic regression analysis on factors with statistical differences.Among the 80 patients who underwent laparoscopic radical resection for colorectal cancer,18 had dynamic intestinal obstruction,with an incidence rate of 22.50%;Univariate analysis showed that there were statistically significant differences between the two groups in TNM staging,preoperative intestinal obstruction,history of abdominal surgery,preoperative anemia,lymph node metastasis,and preoperative hypoalbuminemia(χ^(2)=18.148,7.681,8.119,10.904,9.395,P=0.000,0.003,0.006,0.005,0.001);Logistic regression analysis showed that TNM stage III,preoperative intestinal obstruction,and history of abdominal surgery were independent risk factors for the occurrence of dynamic intestinal obstruction after laparoscopic radical resection of colorectal cancer(P<0.05 and OR>1).Conclusion The occurrence of dynamic intestinal obstruction in rectal cancer patients after laparoscopic radical surgery is related to TNM stage III and preoperative intestinal obstruction.Targeted preventive measures should be formulated in a timely manner to reduce dynamic intestinal obstruction.