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[目的]探讨中低位直肠癌前切除术后吻合口瘘的原因和预防措施。[方法]回顾性分析1998年1月至2007年12月193例中低位直肠癌低位前切除术病例的临床资料。[结果]193例中低位直肠癌低位前切除术患者中有12例发生术后吻合口瘘,吻合口瘘发生率为6.2%,其中男性10例,女性2例;肿瘤超过1/2周肠管10例,小于1/2周肠管2例;Dukes’B期1例,C期11例;合并糖尿病8例,无合并糖尿病4例;合并肠梗阻9例,无合并肠梗阻3例;术前放疗5例,无术前放疗7例;低蛋白血症10例,无低蛋白血症2例;明显贫血10例,无明显贫血2例。[结论]患者的性别、肿瘤的大小、Dukes’分期、贫血、低蛋白血症、术前放疗、合并糖尿病及合并肠梗阻等因素与吻合口瘘的发生密切相关。针对以上因素采取积极的预防措施可减少中低位直肠癌低位前切除术后吻合口瘘的发生。
[Objective] To investigate the causes and preventive measures of anastomotic fistula after low and middle rectal cancer resection. [Methods] The clinical data of 193 cases of low and middle rectal cancer patients with low anterior resection from January 1998 to December 2007 were retrospectively analyzed. [Results] Anastomotic fistula was found in 12 of the 193 cases with low anterior resection of low rectal cancer. The incidence of anastomotic fistula was 6.2%, including 10 males and 2 females. 10 cases, less than 1/2 weeks intestine in 2 cases; Dukes’B period in 1 case, C period in 11 cases; 8 cases with diabetes mellitus, 4 cases without diabetes mellitus; 9 cases with intestinal obstruction, 3 cases without intestinal obstruction; Radiotherapy in 5 cases, without preoperative radiotherapy in 7 cases; hypoalbuminemia in 10 cases, no hypoproteinemia in 2 cases; 10 cases of obvious anemia, no obvious anemia in 2 cases. [Conclusion] The factors such as sex, size of tumor, Dukes’ stage, anemia, hypoproteinemia, preoperative radiotherapy, combined diabetes mellitus and intestinal obstruction are closely related to the occurrence of anastomotic fistula. Taking the above factors to take active preventive measures can reduce the incidence of anastomotic fistula after low anterior resection of low and middle rectal cancer.