结直肠癌合并脑梗死患者术后并发症分析
于秀芝;刘海龙;
摘要(Abstract)：
目的探讨结直肠癌合并脑梗死患者术后并发症,旨在提高手术成功率。方法收集我院行结直肠癌手术182例患者,按照入院时CT或MRI检查结果是否存在梗死灶分为梗死组60例和非梗死组122例。2组均采取直肠低位前切除术、腹会阴联合直肠癌根治术、左结肠切除术及右结肠切除术治疗。对2组术前冠心病、糖尿病、高血压、心电图改变、肺部疾病、贫血及低蛋白血症等伴随疾病及术后肺部感染、肠梗阻、吻合口瘘、肛门排气延迟(3d以上)、心律失常及再次大面积脑梗死等并发症的发生率进行统计,并对2组病死率进行分析。结果梗死组术后肺部感染、肠梗阻及肛门排气延迟发生率显著高于非梗死组(P<0.05),而术后2组吻合口瘘、手术切口感染、心律失常及再次大面脑梗死发生率比较差异无统计学意义(P>0.05)。2组术后病死率差异无统计学意义(梗死组:3.3%,非梗死组:2.7%,P>0.05)。结论脑梗死患者较非脑梗死患者结直肠癌术后肺部感染、肠梗阻及肛门排气延迟的发生率显著提高,因此,术前采取积极的对症治疗措施,同时在术后加强肺部感染及肠梗阻的预防,才能减少脑梗死患者结直肠癌术后的病死率。
关键词(KeyWords)： 脑梗死;结直肠癌;术前合并疾病;术后并发症;干预
基金项目(Foundation):
作者(Authors): 于秀芝;刘海龙;
参考文献(References)：
- [1]张冠中,姬祥龙.脑卒中相关的生活方式危险因素探讨[J].中华健康管理学杂志,2013,7(5):343-344.
- [2]Hsiao CL,Tsai YH,Lin SK.Massive Epistaxis from Internal Carotid Pseudoaneurysm during Acute Ischemic Stroke in a Patient with Nasopharyngeal Carcinoma[J].Acta Neurol Taiwan,2014,23(3):113-118.
- [3]Liu Y,Liang Z,Qin C,et al.Clinical features of ischemic stroke in patients with nasopharyngeal carcinoma[J].Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,2015,50(5):411-414.
- [4]谢景泉,何琳,陈搏之,等.结直肠癌患者术后并发症及影响因素分析[J].浙江临床医学,2014,16(4):624-625.
- [5]艾正友.结直肠癌患者合并脑卒中的预后及影响因素分析[J].中国实用神经疾病杂志,2015,18(20):6-8.
- [6]宋伟华,李晓勇,周百中,等.腹腔镜结直肠癌根治术治疗老年结直肠癌患者的疗效及对胃肠功能的影响[J].中国老年学杂志,2014,34(23):6 624-6 625;6 626.
- [7]An Q,Yu T,Cao X,et al.Comparative analysis of postoperative complications on elderly colorectal cancer patients over 65years with and without comorbid cardiovascular diseases[J].Zhonghua Wei Chang Wai Ke Za Zhi,2016,19(9):1 035-1 039.
- [8]Kim YW,Kim IY.Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians[J].Clin Interv Aging,2016,19(11):689-697.
- [9]Radulovic M,Anand P,Korsten MA,et al.Targeting Ion Channels:An Important Therapeutic Implication in Gastrointestinal Dysmotility in Patients With Spinal Cord Injury[J].J Neurogastroenterol Motil,2015,21(4):494-502.
- [10]Carroll J,Lambrianides AL.Chronic Intestinal PseudoObstruction[J].Am Surg,2016,82(6):126-127.