论文部分内容阅读
目的 探讨直肠癌术后预防性回肠造口延迟回纳的相关危险因素.方法 回顾性分析2014年1月至2014年12月期间中山大学附属第六医院行预防性回肠造口关闭的130例直肠癌患者的临床资料,根据造口回纳时间分为延迟回纳组72例(≥120d)和正常回纳组58例(＜120d).结果 130例患者的肠造口回纳时间为39～692d,中位数为132d.多因素分析结果提示,术后辅助化疗(OR=14.106,P=0.002)、肿瘤距肛缘的距离(OR=0.019,P=0.002)及术后吻合口漏(OR=32.440,P=0.001)是延迟回纳的独立危险因素,术后辅助化疗及发生吻合口漏患者的回纳时间延长,随肿瘤距肛缘的距离缩短,回纳时间延长.结论 直肠癌术后辅助化疗、肿瘤距肛缘的距离短和术后发生吻合口漏会延迟预防性回肠造口的关闭时间.“,”Objective This study aimed to discuss the risk factors associated with the delay reversal ileostomy following sphincter-preserving surgery for rectal cancer.Methods Clinical data were collected retrospectively on 130 consecutive patients undergoing defunctioning ileostomy following sphincter-preserving surgery for rectal cancer,between January 2014 and December 2014 in the Sixth Affiliated Hospital of Sun Yat-sen University.According to the reversal time of ileostomy,the patients were divided into two groups,including the delay reversal ileostomy group(≥120 d,n=72)and the normal ileostomy group(＜120 d,n=58).Results One hundred and thirty patients were studied(median time to reversal 132 d,range 39–692 d).Logistic regression model showed that adjuvant chemotherapy(OR=14.106,P=0.002),distance of tumor from the anal verge(OR=0.019,P=0.002),and anastomotic leakage(OR=32.440,P=0.001) were significant independent risk factors for delayed reversal.Time to reversal was significantly longer in those patients who had adjuvant chemotherapy,anastomotic leakage,and short distance of tumor from the anal verge.Conclusion Adjuvant chemotherapy,short distance of tumor from the anal verge,and anastomotic leakage are the independent risk factors for delay reversal ileostomy following sphincter-preserving surgery for rectal cancer.