基于倾向性评分匹配方法的结肠癌根治术后发生吻合口漏的围术期相关危险因素分析

doi:10.3969/j.issn.1009-976X.2021.05.012

摘要/Abstract

摘要： 目的探讨结肠癌根治术后发生吻合口漏的围术期相关危险因素。方法回顾性收集2019年1月至2021年6月在中山大学孙逸仙纪念医院行择期结肠癌根治术的患者病历资料,按照术后是否发生吻合口漏对患者的病历资料分别作单因素分析、多因素Logistic回归分析以及倾向性评分匹配（PSM）分析,筛选出结肠癌根治术后发生吻合口漏的围术期相关危险因素。结果本研究共纳入患者428例,其中术后发生吻合口漏有17例,发生率为3.97%。多因素分析发现：高龄、男性、手术出血量多、术前白蛋白低、开放手术与术后发生吻合口漏相关（P<0.05）;采用PSM控制年龄和性别后,发现术前白蛋白低于30 g/L、术中出血量>300 mL与吻合口漏发生相关（P<0.05）,开放手术未见显著性差异（P=0.079）。结论手术出血量多及术前白蛋白低,是导致吻合口漏的独立危险因素。

关键词: 结肠癌, 吻合口漏, 危险因素, 倾向性评分匹配

Abstract: Objective To investigate the perioperative risk factors of anastomotic leakage following radical resection of colon cancer. Methods We conducted a retrospective study and involved all patients who underwent radical resection of colon cancer between January 2019 and June 2021 at Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Univariate analysis, multivariate logistic regression analysis and propensity score matching （PSM） analysis were performed according to whether anastomotic leakage occurred after operation to evaluate the risk factors of anastomotic leakage following radical resection of colon cancer. Results 428 patients were included in this study and anastomotic leakage occurred in 17 patients, with an incidence of 3.97%. Multivariate analysis revealed that advanced age, male gender, more intraoperative blood loss, low preoperative albumin, and open surgery were associated with postoperative anastomotic leakage （P<0.05）; In order to control age and gender, PSM was then performed and concluded that preoperative albumin less than 30 g/L and intraoperative blood loss >300 ml were associated with the occurrence of anastomotic leakage （P<0.05）, and there was no significant difference in open surgery （P=0.079）. Conclusions More intraoperative blood loss and low preoperative albumin were independent risk factors leading to anastomotic leakage.

Key words: colon cancer, anastomotic leakage, risk factors, propensity score matching

中图分类号:

R619+.9

邹军, 杨淑婷, 王侃, 赵子然. 基于倾向性评分匹配方法的结肠癌根治术后发生吻合口漏的围术期相关危险因素分析[J]. 岭南现代临床外科, 2021, 21(05): 551-555.

ZOU Jun, YANG Shu-ting, WANG Kan, ZHAO Zi-ran. Perioperative risk factors for anastomotic leakage following radical resection of colon cancer based on propensity score matching[J]. Lingnan Modern Clinics In Surgery, 2021, 21(05): 551-555.

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