中国普外基础与临床杂志

中国普外基础与临床杂志

腹会阴联合直肠癌根治术后发生造口旁疝的影响因素

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目的 探讨腹会阴联合直肠癌根治术(Miles 术)后造口旁疝形成的相关危险因素,为造口旁疝的预防提供科学依据。 方法 回顾性分析 2011 年 5 月至 2015 年 5 月期间在徐州医科大学附属医院普外科行直肠癌 Miles 术的 218 例患者的临床资料,收集 15 项可能影响造口旁疝发生的因素,采用单因素分析和非条件二分类 logistic 回归分析方法探索它们对造口旁疝发生的影响。 结果 218 例患者随访期间发生造口旁疝 55 例,造口旁疝的发生率为 25.23%。单因素分析结果显示:年龄、腹部皮下脂肪厚度、体质量指数(BMI)、造口途径及合并高血压情况均与术后造口旁疝的形成有关(P<0.05);非条件二分类 logistic 回归分析结果显示:高龄、腹部皮下脂肪厚度厚、超重肥胖及经腹膜造口均是 Miles 术后造口旁疝形成的独立危险因素(P<0.05)。 结论 对于存在危险因素的患者,在行直肠癌 Miles 术时需选择合理的造口途径,以预防造口旁疝的发生。

Objective To investigate the risk factors associated with the formation of parastomal hernia after Miles operation, and to provide scientific evidence for the prevention of parastomal hernia. Methods The clinical data of 218 patients with rectal cancer who undergoing Miles operation in the Affiliated Hospital of Xuzhou Medical University between May 2011 and May 2015 were analyzed retrospectively. Fifteen possible factors affecting the occurrence of parastomal hernia were selected. The fifteen related factors were analyzed by single factor analysis and two elements logistic regression analysis. Results A total of 55 patients with parostomy hernia occurred in 218 patients during follow-up period, and the incidence of parastomal hernia was 25.23%. Univariate analysis showed that age, thickness of subcutaneous fat in abdomen, BMI, stoma pathway, and hypertension were related to the formation of parastomal hernia after Miles operation (P<0.05). Further two elements logistic regression analysis showed that, advanced age, thickness of subcutaneous fat in abdomen, BMI>25 kg/m2, and transperitoneal were independent risk factors for the formation of parastomal hernia after Miles operation (P<0.05). Conclusion For patients with risk factors, it is very important to choose optimum stoma pathway during Miles operation to avoid the occurrence of formation of parastomal hernia after Miles operation.

关键词: 造口旁疝; Miles术; 直肠癌; 危险因素

Key words: parastomal hernia; Miles operation; rectal cancer; risk factor

引用本文: 朱乐乐, 王飞通, 刘星, 魏鑫, 牛坚, 刘斌. 腹会阴联合直肠癌根治术后发生造口旁疝的影响因素. 中国普外基础与临床杂志, 2018, 25(8): 964-969. doi: 10.7507/1007-9424.201801041 复制

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