發(fā)布時間：2018-04-30 13:13

  本文選題：結(jié)腸癌D3根治術(shù) + 術(shù)后并發(fā)癥　； 參考：《山東大學(xué)》2015年碩士論文

【摘要】：目的：本文通過對我院胃腸外科2008.01.01-2014.0101六年間行結(jié)腸癌D3根治術(shù)后患者1124例,術(shù)后32例出現(xiàn)吻合口瘺的回顧性分析,探討結(jié)腸癌D3根治術(shù)后吻合口瘺的原因、診斷、后期治療以及預(yù)防措施。材料及方法：本回顧性分析2008年1月1日至2014年1月1日收治的1124例結(jié)腸癌根治術(shù)32例術(shù)后吧并發(fā)吻合口瘺患者的臨床資料,比較性別、年齡、體型、糖尿病、術(shù)前低蛋白血癥、腫瘤位置、腫瘤分期、手術(shù)方式、手術(shù)時間長短等對術(shù)后吻合口瘺的影響。結(jié)果：1124例患者中32例術(shù)后發(fā)生吻合口瘺,發(fā)生率為2.8%。左半結(jié)腸癌499例術(shù)后吻合口瘺23例,右半結(jié)腸癌513例術(shù)后吻合口瘺8例,橫結(jié)腸癌112例術(shù)后吻合口瘺1例。按Dukes分期標(biāo)準(zhǔn),A期178例術(shù)后吻合口瘺4例,B期123例術(shù)后吻合口瘺3例,C期535例術(shù)后吻合口瘺17例,D期288例術(shù)后吻合口瘺8例。在所分析的9個因素中,性別、年齡、體型、糖尿病、術(shù)前低蛋白血癥、腫瘤位置、手術(shù)時間與吻合口瘺的發(fā)生存在統(tǒng)計學(xué)意義,而手術(shù)方式和腫瘤分期與術(shù)后吻合口瘺的發(fā)生無明顯相關(guān)。結(jié)論：結(jié)腸癌D3根治術(shù)后吻合口瘺多發(fā)生在左半結(jié)腸,性別、年齡、體型、糖尿病、術(shù)前低蛋白血癥、腫瘤位置、手術(shù)時間與吻合口瘺的發(fā)生有明顯相關(guān)性。吻合口瘺的治療首選保守支持治療。急性期應(yīng)完全禁飲食,完全腸外營養(yǎng),待狀況好轉(zhuǎn)后積極開展無渣飲食。盡早恢復(fù)腸內(nèi)飲食有助于病情恢復(fù)。
[Abstract]:Objective: to investigate the causes and diagnosis of anastomotic fistula after radical resection of colon cancer in 1124 cases and 32 cases after radical resection of colon cancer during 2008.01.01-2014.0101 in our hospital. Late treatment and preventive measures. Materials and methods: from January 1, 2008 to January 1, 2014, we retrospectively analyzed the clinical data of 32 patients with anastomotic fistula after radical resection of colon cancer, and compared their sex, age, body size, diabetes mellitus. The effect of preoperative hypoproteinemia, tumor location, tumor staging, operation mode and operation time on postoperative anastomotic fistula. Results 32 cases of anastomotic fistula occurred in 32 cases of 1 124 cases. The incidence of anastomotic leakage was 2.8%. Anastomotic fistula was found in 23 cases of 499 cases of left colon cancer, 8 cases of anastomotic fistula in 513 cases of right colon cancer and 1 case of anastomotic fistula in 112 cases of transverse colon cancer. According to the standard of Dukes stage A, there were 4 cases of anastomotic fistula in stage A and 123 cases in stage B, 3 cases in stage C, 535 cases in stage C, 17 cases of anastomotic fistula in D stage and 288 cases of postoperative anastomotic fistula in 8 cases. Among the 9 factors analyzed, sex, age, body size, diabetes mellitus, preoperative hypoproteinemia, tumor location, operative time and anastomotic leakage were statistically significant. However, there was no significant correlation between postoperative anastomotic fistula and surgical operation and tumor staging. Conclusion: anastomotic fistula after radical resection of colon cancer D3 is associated with the occurrence of anastomotic fistula in the left colon, sex, age, body type, diabetes mellitus, preoperative hypoproteinemia, tumor location and operation time. The first choice of treatment for anastomotic fistula is conservative support therapy. Diet and parenteral nutrition should be completely prohibited in acute period. Early recovery of enteral diet is helpful for recovery.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735.35

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 Fabio Grizzi;Paolo Bianchi;Alberto Malesci;Luigi Laghi;;Prognostic value of innate and adaptive immunity in colorectal cancer[J];World Journal of Gastroenterology;2013年02期

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本文編號：1824696