直肠癌患者末端回肠保护性造口回纳失败的相关危险因素分析

发布时间：2018-05-27 09:32

  本文选题：直肠癌 + 低位前切除　； 参考：《浙江大学》2017年硕士论文

【摘要】：目的:探讨直肠癌术后患者末端回肠保护性造口回纳失败的的相关危险因素。方法:回顾性分析了 2010年11月到2016年4月浙江大学附属邵逸夫医院收治的1197例病理确诊的原发性直肠癌患者的临床资料,最后按纳入和排除标准从中筛选出206例接受了直肠癌DIXON手术+回肠保护性造口的患者,并进一步分为两组:回纳成功组和回纳失败组。回纳失败定义为随访期内未回纳(12月)或回纳后6个月内再次行造口术。将患者置入两组后,评价回纳失败的相关危险因素。结果:206例造口患者中,179例(86.9%)回纳成功,27(13.1%)例回纳失败。造口回纳手术距造口手术的中位时间为5月(5.65±2.54月)。单因素分析显示回纳失败的相关危险因素包括远处转移(p=0.001)、Ⅳ期(根据AJCC第七版癌症分期)(p=0.018)和吻合口相关并发症(p=0.000)。多因素分析显示回纳失败的独立危险因素为吻合口相关并发症(OR,21.963;95%CI,7.464-64.432;p=0.000)。结论:对行直肠癌低位前切除+回肠保护性造口术的患者来说,吻合口相关并发症会增加回肠造口回纳失败的风险,术前应对患者进行相应的告知。
[Abstract]:Objective: to investigate the risk factors of terminal ileal protective anastomosis failure in patients with rectal cancer after operation. Methods: the clinical data of 1197 pathologically diagnosed primary rectal cancer patients admitted to run Shaw Hospital of Zhejiang University from November 2010 to April 2016 were retrospectively analyzed. According to the criteria of inclusion and exclusion 206 patients were selected and divided into two groups: successful resuscitation group and failed ileal anastomosis group. Failure of resuscitation is defined as the failure to perform ostomy during the follow-up period (12 months) or within 6 months of resuscitation. Patients were placed in two groups to evaluate the risk factors associated with failed resuscitation. Results among 206 cases of anastomosis, 179 cases (86.9%) were successful in resuscitation and 2713.1cases were failed in resuscitation. The median time between resuscitation and operation was 5.65 卤2.54 months. Univariate analysis showed that the risk factors associated with failure of resuscitation included distant metastasis, stage 鈪，

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