老年结肠癌并急性肠梗阻术后并发症危险因素剖析.docVIP

老年结肠癌并急性肠梗阻术后并发症危险因素剖析 　　doi：10.3969/j.issn.1007-614x.2014.9.19 　　摘 要 目的：探讨老年结肠癌并急性肠梗阻术后并发症危险因素。方法：回顾性分析老年结肠癌并急性肠梗阻采用手术治疗后发生并发症的情况，对其可能影响的因素进行分析。结果：出现并发症35例（21.34%），其中右半结肠癌16例患者（19例次），围手术期死亡4例（5.97%）；左半结肠癌19例患者（21例次），围手术期死亡5例（8.06%）。两组并发症、住院时间、死亡率比较，差异无统计学意义（P0.05）。肠梗阻侵袭度评分、ASA分级、APACHE-Ⅱ评分项目与并发症发生相关，与无并发症组比较差异有统计学意义（P0.01）。结论：ASA分级、APACHE-Ⅱ评分、梗阻侵袭程度对结肠癌急性肠梗阻并发症预测有一定的参考价值。根据患者情况采用个性化的手术治疗方案能提高患者的预后。 　　关键词 老年结肠癌 急性肠梗阻 并发症 　　Analysis of risk factors of postoperative complications of elderly colon cancer combined with acute intestinal obstruction 　　Zheng Bo 　　Xinye County Peoples Hospital of Henan Province，473500 　　Abstract Objective：To explore the risk factors of postoperative complications of elderly colon cancer combined with acute intestinal obstruction.Methods：Retrospectively analyzed the postoperative complications situation of elderly colon cancer combined with acute intestinal obstruction，to analyze the influencing factors.Results：35 cases（21.34%）had complications，including 16 cases of right colon cancer patients（19 cases），peri operation period death in 4 cases（5.97%）；the left half colon cancer in 19 patients（21 cases），5 cases of peri operation period death（8.06%）.The difference of the complications， hospitalization time and mortality of the two groups was not significant（P0.05）.Intestinal obstruction invasion score，ASA grade，APACHE- score were related to the complications，compared with non complication group，there were significant difference（P0.01）.Conclusion：ASA score，APACHE- score，obstruction degree of invasion has a certain reference value for forecasting of acute obstruction complication of colon cancer.According to the conditions of patients，the operation of a personalized treatment plan can improve the prognosis of patients. 　　Key words Elderly colorectal cancer；Acute intestinal obstruction；Complication 　　结肠癌的发病率仅次于胃癌、肝癌、食管癌，结肠癌所引起的急性完全性肠梗阻属闭袢式梗阻，发生率8%～29%[1]，梗阻近侧结肠，特别是盲肠高度扩张，结肠壁因肠腔高压影响，血运障碍，可出现缺血、坏死和穿孔，引起急性弥漫性腹膜炎。随着人口老龄化加剧，梗阻性结肠癌发病率也在提高，患者多需要急