永久性结肠造瘘术后结肠造瘘口并发症的临床分析

目的探讨结肠造瘘口并发症发生的原因、特点、预防以及处理。方法回顾分析我院2005年1月至2011年1月收治的136例直肠癌永久性结肠造瘘（Miles）术后结肠造瘘口患者的临床资料，分析结肠造瘘口并发症发生的原因、特点以及防治措施。结果结肠造瘘口术后并发症发生率为22．1％（30／136），其中66．7％（20／30）的并发症发生在术后1年内。经统计分析发现：结肠造瘘口术后并发症与腹壁外段造口肠管长度〈2cm（P=0．016）、腹壁切口直径〈3cm（P=0．017）、年龄≥60岁（P=0．084）、体型肥胖／消瘦（P=0．030）、伴发疾病（P=0．021）相关。结论结肠造瘘口并发症有较高的发生率，与手术方式、患者年龄、体形及有无伴发疾病有密切关系。

Clinical study of colostomy complications after Miles operation

Objective To investigate the causes,features,prevention and treatment of colostomy-related complications after Miles operation. Methods We retrospectively analyzed the clinical data of 136 cases of colostomy after Miles operation for rectal cancer from Jan. 2005 to Jan. 2011. Results Post-operative colostomy related complications were developed in 22. 1% （30/136） of the patients and 66. 7 % （20/30） of complications occurred within 1 year. The incidence of complications is closely associated with demographic and disease factors including intestine length less than 2 cm outside abdominal wall （ P = 0. 016 ）, incision diameter below 3 cm （ P = 0. 017）, above 60 years old （ P = 0. 084）, obesity or thinness （ P = 0. 030）, as well as other concomitant diseases （P = 0. 021 ）. Conclusion High prevalence of colostomy-related complications is found in this study, which is related to operation approach, age of patient, body size as well as other concomitant diseases.