老年直肠癌术后并发肠梗阻的临床危险因素
发布时间：2018-11-02 18:49
【摘要】：目的探讨老年直肠癌根治术后并发肠梗阻(POI)的临床危险因素,旨在提高老年直肠癌根治手术治疗效果。方法回顾性分析肛肠外科行直肠癌根治手术的645例患者分别应用单因素及Logistic多因素分析结直肠癌根治术后并发肠梗阻的危险因素。结果结直肠癌患者根治术后POI发生率为8.99%(58/645),经单因素分析显示,年龄80岁、肿瘤TNM分期、肿瘤分级、既往手术史、术前合并POI、手术方式、麻醉方式、美国麻醉师协会(ASA)分级、镇痛药物的应用均与POI发生关系密切(P0.05)。经Logistic多因素显示,N2分期(OR:5.66;95%CI:1.589~8.123)、结直肠肿瘤切除史(OR:4.223;95%CI:1.269~6.425)、左半结肠切除术(OR:4.112;95%CI:1.326~6.986)、右半结肠切除术(OR:3.896;95%CI:1.245~6.112)、ASA分级(OR:3.745;95%CI:1.231~5.210)、阿片类药物的应用(OR:4.986;95%CI:1.232~7.025)是POI的独立危险因素,而腹腔镜手术(OR:3.652;95%CI:1.023~6.002)是POI的保护因素。结论结直肠癌术后POI的发生是由多种因素引起,对于ASAⅢ~Ⅳ级患者选取腹腔镜手术治疗可降低POI发生风险,改善预后。
[Abstract]:Objective to investigate the clinical risk factors of (POI) complicated with intestinal obstruction after radical resection of rectal cancer in elderly patients. Methods the risk factors of intestinal obstruction after radical resection of colorectal cancer were analyzed retrospectively by single factor and Logistic multivariate analysis in 645 patients undergoing radical resection of rectal cancer. Results the incidence of POI was 8.99% (58 / 645) in patients with colorectal cancer after radical operation. Univariate analysis showed that age was 80 years old, tumor TNM staging, tumor grading, previous operation history, preoperative POI, operation and anesthesia. The (ASA) classification and analgesic use of American anaesthetist association were closely related to the occurrence of POI (P 0.05). By Logistic, N2 staging (OR:5.66;95%CI:1.589~8.123), resection history of colorectal neoplasms (OR:4.223;95%CI:1.269~6.425), left hemicolectomy (OR:4.112;) were detected. 95%CI:1.326~6.986, right hemicolectomy (OR:3.745;95%CI:1.231~5.210), OR:4.986; 95%CI:1.232~7.025 is an independent risk factor for POI, while laparoscopic surgery (OR:3.652;95%CI:1.023~6.002) is a protective factor for POI. Conclusion the occurrence of POI after colorectal cancer operation is caused by many factors. For ASA 鈪，
本文编号：2306655
[Abstract]:Objective to investigate the clinical risk factors of (POI) complicated with intestinal obstruction after radical resection of rectal cancer in elderly patients. Methods the risk factors of intestinal obstruction after radical resection of colorectal cancer were analyzed retrospectively by single factor and Logistic multivariate analysis in 645 patients undergoing radical resection of rectal cancer. Results the incidence of POI was 8.99% (58 / 645) in patients with colorectal cancer after radical operation. Univariate analysis showed that age was 80 years old, tumor TNM staging, tumor grading, previous operation history, preoperative POI, operation and anesthesia. The (ASA) classification and analgesic use of American anaesthetist association were closely related to the occurrence of POI (P 0.05). By Logistic, N2 staging (OR:5.66;95%CI:1.589~8.123), resection history of colorectal neoplasms (OR:4.223;95%CI:1.269~6.425), left hemicolectomy (OR:4.112;) were detected. 95%CI:1.326~6.986, right hemicolectomy (OR:3.745;95%CI:1.231~5.210), OR:4.986; 95%CI:1.232~7.025 is an independent risk factor for POI, while laparoscopic surgery (OR:3.652;95%CI:1.023~6.002) is a protective factor for POI. Conclusion the occurrence of POI after colorectal cancer operation is caused by many factors. For ASA 鈪，
本文编号：2306655
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