结直肠术后并发吻合口瘘的危险因素探讨

摘要

Objective To explore the incidence rate of anastomotic leaks due to colorectal surgery and the causes and influencing factors of this disorder.Methods The clinical data on 124 patients with colon cancer who had undergone colorectal surgery during the period of January 2005 and December 2011 were retrospectively analyzed.Sex,age(group of younger than 60 years and group of older than 60years),types of tumor differentiation,anastomotic patterns,and anastomotic planes were statistically analyzed.Results Anastomotic leaks occurred in 11 patients,with a rate of 8.9％.The incidence rate of anastomotic leaks did not differ significant among different degree of tumor differentiation(P＞0.05).There were statistical differences in the rate of anastomotic leaks among the groups of different sex,age,anastomotic patterns,and anastomotic planes(P＜0.05).Logistic regression analysis showed that sex,age,anastomotic patterns,and anastomotic planes associated with anastomosis leaks(P＜0.05).Conclusions The incidence rate of anastomotic leaks due to colorectal surgery is associated with multiple risk factors including sex,age,anastomotic patterns,and anastomotic planes.The incidence rate differs in different anastomotic planes;the lower the anastomotic planes,the higher the incidence of anastomotic leaks.%目的 探讨结直肠手术后并发吻合口瘘的发生率及吻合口瘘发生的原因和影响因素.方法 对我院2005年1月至2011年12月收治的124例行结直肠手术的结肠癌患者的临床资料进行回顾性分析,并对患者按性别、年龄(60岁以上组和60岁以下组)、肿瘤分化类型、吻合方式、不同吻合平面进行统计分析.结果 本组患者发生吻合口瘘的有11例,发生率为8.9％.不同肿瘤分化程度患者术后吻合口瘘发生率差异无统计学意义(P＞0.05);不同性别、年龄患者与采用不同吻合方式及吻合平面的患者术后吻合口瘘发生率差异有统计学意义(P＜0.05).Logistic回归分析显示,性别、年龄、吻合方式及吻合平面与吻合口瘘相关(P＜0.05).结论 结直肠手术后吻合口瘘的发生与性别、年龄、吻合方式及吻合平面多个危险因素有关,不同吻合平面的手术吻合口瘘发生率不同,吻合平面越低,吻合口瘘发生率越高.