结肠癌根治术患者住院时间延长的围术期相关危险因素分析

doi:10.3969/j.issn.1009-976X.2022.06.005

摘要/Abstract

摘要： 目的探讨导致结肠癌根治术患者的住院时间延长的围术期相关危险因素。方法收集2019年1月~2021年6月在中山大学孙逸仙纪念医院行结肠癌根治术的患者病历资料进行回顾性分析,根据住院时间分为住院时间延长组和非延长组,将两组资料进行单因素和多因素分析,从而得出导致结肠癌根治术患者的住院时间延长的围术期相关危险因素。结果共426名患者纳入本次研究,单因素分析显示年龄>64岁、ASAⅢ级及以上、TNM分期Ⅳ期、合并糖尿病、合并心脏疾病、术前淋巴细胞<1.565×10⁹、术前白蛋白<36 g/L、术前D二聚体>0.49 U/L、术前CRP>3.46、手术时长>196 min、非腹腔镜手术、术中晶体输注量>1000 mL、术中出血量>50 mL、术后白蛋白<29 g/L、术后淋巴细胞<0.81×10⁹、术后>4天排便、术后ICU停留、术后并发症、输血治疗为与患者住院时间延长相关（P<0.05,OR>1）;多因素分析显示手术时长>196 min、术后并发症、术后>4天排便和患者住院时间延长相关（P<0.05,OR>1）。结论手术时长>196 min、术后并发症、术后>4天排便是导致结肠癌根治术患者住院时间延长的独立危险因素。

关键词: 结肠癌, 住院时间, 危险因素

Abstract: Objective To investigate perioperative risk factors associated with prolonged length of stay in patients who underwent radical resection of colon cancer. Methods We organized a retrospective study of all patients who underwent radical resection of colon cancer from 2019.01 to 2021.06 in Sun Yat-sen Memorial Hospital. All patients were divided into two groups based on their length of stay. Univariate and multivariate logistic regression analyses were conducted. Results 426 patients were enrolled in this study. Univariate study showed that age >64 y, ASA Ⅲ~Ⅴ, Tumor stage Ⅳ, diabetes mellitus, cardiac disease, preoperative （preop） lymphocyte <1.565×10⁹, preop albumin <36 g/L, preop D-dimer >0.49 U/L, preop CRP>3.46, duration of surgery >196 min, non-laparoscope, crystalloid infusion >1000 ml, amount of bleeding >50 ml, postoperative （postop）complications occurrence, postop ICU stay, postop albumin <29 g/L, postop lymphocyte <0.81×10⁹, postop defecating time >4 days and blood transfusion were associated with prolonged length of stay （P<0.05, OR>1）. Multivariate study showed that duration of surgery >196 min， postop defecating time >4 days and postop complications occurrence were associated with prolonged length of stay （P<0.05， OR>1）. Conclusion Duration of surgery >196 min， postop defecating time >4 days and postop complications occurrence were independent risk factors associated with prolonged length of stay in patients who underwent radical resection of colon cancer.

Key words: colon cancer, length of stay, risk factors

中图分类号:

R619+9

吴佳瑶, 王成立, 周声宁, 王侃. 结肠癌根治术患者住院时间延长的围术期相关危险因素分析[J]. 岭南现代临床外科, 2022, 22(06): 555-559.

WU Jia-yao, WANG Cheng-li, ZHOU Sheng-ning, WANG Kan. Analysis of perioperative risk factors associated with prolonged length of stay in patients who underwent radical resection of colon cancer[J]. Lingnan Modern Clinics In Surgery, 2022, 22(06): 555-559.

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