临床外科杂志 ›› 2018, Vol. 26 ›› Issue (9): 671-673.doi: 10.3969/j.issn.10056483.2018.06.009

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食管癌根治术后吻合口漏的危险因素分析

  

  1. 210008  南京医科大学鼓楼临床医学院胸外科
  • 收稿日期:2017-08-03 出版日期:2018-09-20 发布日期:2018-09-20
  • 通讯作者: 陈宝俊,Email:erg3335@163.com

The risk factors analysis of anastomotic leakage in treatment of radical esophagectomy

  1. Department of Thoracic Surgery,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China
  • Received:2017-08-03 Online:2018-09-20 Published:2018-09-20

摘要: 目的  探讨食管癌根治术后吻合口瘘发生的危险因素。方法  回顾性分析381例行根治性手术的食管癌病人的临床资料。选择性别、年龄、ASA评分、既往高血压、糖尿病史、手术情况、术前及术后实验室检查结果等对食管癌术后吻合口漏发生可能有影响的非重复特征性因素进行单因素分析,并采用Logistic回归分析其主要危险因素。结果  行食管癌根治术病人381例中,发生吻合口漏37例。单因素分析表明,肿瘤部位、手术方式、吻合部位、吸烟史、中重度阻塞性肺疾病、术中出血量、手术时间、术后第二天CRP水平为其影响因素。Logistic回归分析示,吻合部位、吸烟史、术中出血量及术后第二天CRP水平是吻合口漏的独立危险因素。结论 颈部吻合、吸烟史及术中出血流量是吻合口漏发生的重要因素,术后第二天CRP水平在早期诊断吻合口漏有一定的应用价值。

关键词: 经皮肾镜钬激光碎石取石术, 微通道, 标准通道, 复杂性肾结石

Abstract: [Abstract]  objective    To analyze the risk factors of anastomotic leakage after treatment of radical esophagectomy for esophageal cancer.Methods  The clinical data of 381 patients with esophageal cancer undergoing radical esophagectomy were analyzed retrospectively.Gender,age,ASA score,previous hypertension,diabetes history,surgical condition,preoperative and postoperative laboratory test results,and other factors that may affect the occurrence of anastomotic leakage after esophageal cancer were selected for univariate analysis.Logistic regression was used to analyze the main risk factors.Results  Thirtyseven patients of 381 cases with esophagectomy occurr ed anastomotic leakage and the incidence rate was 9.7%(37/381).In univariate analysis,tumor location,surgery type,anastomotic site,smoking,moderately severely COPD,bleeding volume,operating time and the CRP on second day after operation were determined as influence factors.The multivariate analysis showed that anastomotic site,smoking,bleeding volume and the CRP on second day after operation are independent risk factors for anastomotic leakage after esophagectomy.ConclusionAnastomotic site,bleeding volume and smoking are important factors for the anastomotic leakage,and the CRP on second day after operation is a    useful marker of prediction about early anastomotic leakage of esophagectomy.

Key words:  ,  , percutaneous nephrolithotomy holmium laser lithotripsy, microchannels, standard channels, complex renal stones

[1] 魏军 饶婷 蒋焜 余伟民 宁金卓 程帆. 标准通道经皮肾镜钬激光碎石取石术联合微通道技术治疗复杂性肾结石的临床疗效观察[J]. 临床外科杂志, 2018, 26(10): 770-772.
[2] 董锐 徐肇斌 王国举等 . 微通道与标准通道经皮肾镜碎石术治疗复杂性输尿管上段结石的临床对比分析 [J]. 临床外科杂志, 2013, 21(1): 50-52.
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