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目的研究老年大肠癌切除患者术后吻合口漏发生原因、预防及治疗方案。方法老年大肠癌切除患者500例,患者中共39例发生吻合口漏,采用自拟问卷调查表对患者一般资料进行分析,对吻合口瘘发生原因进行单因素和多因素分析,根据吻合口瘘发生原因采取有效的措施进行预防、治疗。结果 500例老年大肠癌切除术患者39例发生吻合口漏,发生率为7.80%,发生原因排在前3位的分别为患者自身因素、新辅助化疗、肠道准备,分别占30.77%、25.61%、15.38%。单因素结果显示:老年大肠癌切除术患者术后吻合口漏发生率与年龄、高血压、放化疗、手术方式及淋巴结转移差异无统计学意义(P>0.05);老年大肠癌切除术患者术后吻合口漏发生率与糖尿病、距离肛缘距离关系密切(P<0.05);非条件Logistic多因素分析显示:老年大肠癌切除术患者术后吻合口漏发生率与糖尿病、距离肛缘距离关系密切(P<0.05)。结论老年大肠癌切除术患者术后吻合口漏发生原因相对较多,应根据危险因素做好相应的预防、治疗措施,降低术后吻合口漏发生率。
Objective To study the causes, prevention and treatment of anastomotic leakage after resection of elderly patients with colorectal cancer. Methods 500 cases of elderly patients with colorectal cancer resection, 39 cases of patients with anastomotic leakage occurred, the use of self-questionnaire to analyze the general data of patients, the causes of anastomotic leakage were univariate and multivariate analysis, according to the occurrence of anastomotic leakage Reason to take effective measures to prevent and treat. Results Anastomotic leakage was found in 39 out of 500 cases of elderly patients with colorectal cancer, the incidence rate was 7.80%. The top three causes were patients’ own factors, neoadjuvant chemotherapy and intestinal preparation, accounting for 30.77% and 25.61 %, 15.38%. The results of univariate analysis showed that the incidence of anastomotic leakage in patients with colorectal cancer after resection had no significant difference with age, hypertension, radiotherapy and chemotherapy, operation method and lymph node metastasis (P> 0.05) (P <0.05). Logistic regression analysis showed that the incidence of postoperative anastomotic leakage in patients with colorectal cancer after resection was significantly related to diabetes and the distance from the anal verge Close (P <0.05). Conclusion There are many causes of anastomotic leakage after resection of elderly patients with colorectal cancer. Corresponding prevention and treatment measures should be made according to risk factors to reduce the incidence of anastomotic leakage after operation.