摘要
目的探讨影响结肠癌患者术后并发症发生的风险因素。方法选取2009年1月至2010年4月期间四川大学华西医院胃肠外科中心结直肠外科专业组收治且经病理检查确诊的结肠癌患者114例,根据术后住院期间并发症发生情况分为并发症组和无并发症组,对2组患者临床病理指标和手术情况进行比较,并对相关风险因素进行多因素回归分析。结果 2组患者在手术时间（t=2.034,P=0.032）、患糖尿病（χ2=5.920,P=0.015）、肿瘤分化程度（χ2=7.163,P=0.028）、住院时间（2χ=0.411,P=0.026）和ASA分级（2χ=11.585,P=0.009）方面的差异均有统计学意义;手术时间〉200 min者并发症发生率明显高于≤100 min（2χ=8.884,P=0.003）和100~200 min者（2χ=7.318,P=0.007）;ASA分级中Ⅳ级者并发症发生率明显高于Ⅰ级（2χ=13.426,P=0.000）;肿瘤分化程度中高分化者并发症发生率明显高于中分化（2χ=4.950,P=0.026）和低分化者（2χ=7.476,P=0.006）。多因素分析显示住院时间（P=0.009）、年龄（P=0.024）、是否患糖尿病（P=0.018）和ASA分级（P=0.001）是结肠癌患者术后并发症发生的独立影响因素。结论结肠癌患者术后并发症的风险因素多体现在患者术前身体素质指标方面,提高对高危因素的重视,针对性地制定治疗方案,对改善患者预后有重要意义。
Objective To explore the risk factors influenced postoperative complications of colon cancer.Methods In this study,114 patients diagnosed definitely as colon cancer were enrolled from January 2009 to April 2010 in this hospital.The patients were divided into the complication group and non-complication group according to the occurrence of postoperative complications during hospital day.Furthermore,clinicopathological features and operative parameters of patients were compared in two groups,and independent factors for postoperative complications were identified by multiple regression analysis.Results There were statistical differences between two groups in operation time（t=2.034,P=0.032）,diabetes mellitus（χ2=5.920,P=0.015）,differentiation degree of tumor（χ2=7.163,P=0.028）,hospital stay（χ2=0.411,P=0.026）,and ASA grades（χ2=11.585,P=0.009）.The morbidity of patients with operative time 200 min was significant higher than that ≤100 min（χ2=8.884,P=0.003） and 100-200 min（χ2=7.318,P=0.007）.The morbidity of patients with ASA Ⅳ grade was higher than that with ASA Ⅰ grade（χ2=13.426,P=0.000）.For tumor differentiation,the morbidity of patients with well-differentiated tumor was higher than that with moderately differentiated tumor（χ2=4.950,P=0.026） and poorly differentiated tumor（χ2=7.476,P=0.006）.The hospital stay（P=0.009）,age（P=0.024）,diabetes mellitus（P=0.018）,and ASA grade（P=0.001） were the independent factors for postoperative complications by multivariate regression analysis.Conclusion The physical quality indexes are the mostly common risk factors of postoperative complications for colon cancer,emphasizing on the high-risk factors and making a targeted and individual treatment plan for each patient are of great important to improve the prognosis.
出处
《中国普外基础与临床杂志》
CAS
2011年第2期159-163,共5页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省卫生厅科学研究项目(项目编号:080271)~~
关键词
结肠癌
手术风险
术后并发症
多因素分析
预后
Colon cancer
Operative risk
Postoperative complication
Multifactor analysis
Prognosis
