食管癌术后吻合口瘘发生趋势及相关因素分析

目的:分析食管癌术后并发吻合口瘘的发病趋势,探讨吻合口瘘的相关因素。方法:采用病例对照方法,回顾性分析我院1997年1月-2006年12月间食管癌1028例患者的临床资料。结果:术后并发吻合口瘘67例(6.52%),发生率由1997年的10.35%下降到2006年的2.22%,呈明显下降趋势。手术质量差,患者血红蛋白(Hb)、红细胞(RBC)、血浆蛋白含量低等是发生吻合口瘘的主要原因;患者性别、年龄、空腹血糖在瘘组和非瘘组之间差异无统计学意义(P>0.05)。结论:吻合技术改进和操作熟练可降低吻合口瘘的发生;吻合口瘘发生的原因复杂,术前正确评估患者营养状况、术中规范操作、术后营养支持是预防吻合口瘘的有效措施。

Analysis of the occurrence tendency and relative factors on anastomofic fistula in postoperative esophageal carcinoma

Objective:To investigate the occurrence tendency and relative factors of anastomotic fistula in postoperative esophageal carcinoma.Methods: A total of 1028 cases of esophageal carcinoma were retrospectively analyzed.Results: The incidence of the anastomotic fistula was 6.52%(67 cases).Occurrence rates were 10.35% in 1997,and 2.22% in 2006,that showed a trend of decrease.The bad quality of operation,low level of hemoglobin,red blood cell and total plasma protein were the main factors of postoperative anastomotic fistula.There was no statistical significane between the fistula groups and non-fistula groups in sex,age,plasma glucose(P>0.05).Conclusion: Progress of anastomosis technique and excellent operation play an important role to decrease the incidence of anastomotic fistula;The reason of anastomotic fistula postoperative esophageal carcinoma is many-sided.The effective measures to prevent anastomotic fistula are evaluating nutrition status before operation,standardized operation,nutrition supporting after operation.