本文選題：直腸癌 + 低位前切除��； 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：目的:探討直腸癌術(shù)后患者末端回腸保護(hù)性造口回納失敗的的相關(guān)危險(xiǎn)因素。方法:回顧性分析了 2010年11月到2016年4月浙江大學(xué)附屬邵逸夫醫(yī)院收治的1197例病理確診的原發(fā)性直腸癌患者的臨床資料,最后按納入和排除標(biāo)準(zhǔn)從中篩選出206例接受了直腸癌DIXON手術(shù)+回腸保護(hù)性造口的患者,并進(jìn)一步分為兩組:回納成功組和回納失敗組�；丶{失敗定義為隨訪期內(nèi)未回納(12月)或回納后6個(gè)月內(nèi)再次行造口術(shù)。將患者置入兩組后,評(píng)價(jià)回納失敗的相關(guān)危險(xiǎn)因素。結(jié)果:206例造口患者中,179例(86.9%)回納成功,27(13.1%)例回納失敗。造口回納手術(shù)距造口手術(shù)的中位時(shí)間為5月(5.65±2.54月)。單因素分析顯示回納失敗的相關(guān)危險(xiǎn)因素包括遠(yuǎn)處轉(zhuǎn)移(p=0.001)、Ⅳ期(根據(jù)AJCC第七版癌癥分期)(p=0.018)和吻合口相關(guān)并發(fā)癥(p=0.000)。多因素分析顯示回納失敗的獨(dú)立危險(xiǎn)因素為吻合口相關(guān)并發(fā)癥(OR,21.963;95%CI,7.464-64.432;p=0.000)。結(jié)論:對(duì)行直腸癌低位前切除+回腸保護(hù)性造口術(shù)的患者來(lái)說(shuō),吻合口相關(guān)并發(fā)癥會(huì)增加回腸造口回納失敗的風(fēng)險(xiǎn),術(shù)前應(yīng)對(duì)患者進(jìn)行相應(yīng)的告知。
[Abstract]:Objective: to investigate the risk factors of terminal ileal protective anastomosis failure in patients with rectal cancer after operation. Methods: the clinical data of 1197 pathologically diagnosed primary rectal cancer patients admitted to run Shaw Hospital of Zhejiang University from November 2010 to April 2016 were retrospectively analyzed. According to the criteria of inclusion and exclusion 206 patients were selected and divided into two groups: successful resuscitation group and failed ileal anastomosis group. Failure of resuscitation is defined as the failure to perform ostomy during the follow-up period (12 months) or within 6 months of resuscitation. Patients were placed in two groups to evaluate the risk factors associated with failed resuscitation. Results among 206 cases of anastomosis, 179 cases (86.9%) were successful in resuscitation and 2713.1cases were failed in resuscitation. The median time between resuscitation and operation was 5.65 鹵2.54 months. Univariate analysis showed that the risk factors associated with failure of resuscitation included distant metastasis, stage 鈪，

本文編號(hào)：1941482