【摘要】：目的探討老年直腸癌根治術后并發(fā)腸梗阻(POI)的臨床危險因素,旨在提高老年直腸癌根治手術治療效果。方法回顧性分析肛腸外科行直腸癌根治手術的645例患者分別應用單因素及Logistic多因素分析結(jié)直腸癌根治術后并發(fā)腸梗阻的危險因素。結(jié)果結(jié)直腸癌患者根治術后POI發(fā)生率為8.99%(58/645),經(jīng)單因素分析顯示,年齡80歲、腫瘤TNM分期、腫瘤分級、既往手術史、術前合并POI、手術方式、麻醉方式、美國麻醉師協(xié)會(ASA)分級、鎮(zhèn)痛藥物的應用均與POI發(fā)生關系密切(P0.05)。經(jīng)Logistic多因素顯示,N2分期(OR:5.66;95%CI:1.589~8.123)、結(jié)直腸腫瘤切除史(OR:4.223;95%CI:1.269~6.425)、左半結(jié)腸切除術(OR:4.112;95%CI:1.326~6.986)、右半結(jié)腸切除術(OR:3.896;95%CI:1.245~6.112)、ASA分級(OR:3.745;95%CI:1.231~5.210)、阿片類藥物的應用(OR:4.986;95%CI:1.232~7.025)是POI的獨立危險因素,而腹腔鏡手術(OR:3.652;95%CI:1.023~6.002)是POI的保護因素。結(jié)論結(jié)直腸癌術后POI的發(fā)生是由多種因素引起,對于ASAⅢ~Ⅳ級患者選取腹腔鏡手術治療可降低POI發(fā)生風險,改善預后。
[Abstract]:Objective to investigate the clinical risk factors of (POI) complicated with intestinal obstruction after radical resection of rectal cancer in elderly patients. Methods the risk factors of intestinal obstruction after radical resection of colorectal cancer were analyzed retrospectively by single factor and Logistic multivariate analysis in 645 patients undergoing radical resection of rectal cancer. Results the incidence of POI was 8.99% (58 / 645) in patients with colorectal cancer after radical operation. Univariate analysis showed that age was 80 years old, tumor TNM staging, tumor grading, previous operation history, preoperative POI, operation and anesthesia. The (ASA) classification and analgesic use of American anaesthetist association were closely related to the occurrence of POI (P 0.05). By Logistic, N2 staging (OR:5.66;95%CI:1.589~8.123), resection history of colorectal neoplasms (OR:4.223;95%CI:1.269~6.425), left hemicolectomy (OR:4.112;) were detected. 95%CI:1.326~6.986, right hemicolectomy (OR:3.745;95%CI:1.231~5.210), OR:4.986; 95%CI:1.232~7.025 is an independent risk factor for POI, while laparoscopic surgery (OR:3.652;95%CI:1.023~6.002) is a protective factor for POI. Conclusion the occurrence of POI after colorectal cancer operation is caused by many factors. For ASA 鈪，

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