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目的探讨直肠癌Dixon术后吻合口瘘发生的危险因素、诊断、处理及防治措施。方法回顾性分析2006年1月至2010年12月我院收治的169例直肠癌Dixon手术患者的临床资料,分析直肠癌患者行Dixon手术后发生吻合口瘘的危险因素。结果本组患者术后发生吻合口瘘18例(10.7%),15例予以全身营养支持、加强全身抗感染治疗及局部加强冲洗引流等非手术治疗,另3例再次手术,均获治愈。结论患者的性别、年龄、吸烟酗酒者、术前合并有贫血、低蛋白血症、糖尿病及不全性肠梗阻,肿块距离肛缘≤5cm等都是是吻合口瘘发生的危险因素。早期发现、早期诊断、合理的治疗措施是治愈吻合口瘘的关键。
Objective To investigate the risk factors, diagnosis, treatment and prevention and treatment of anastomotic fistula after Dixon rectal cancer. Methods The clinical data of 169 patients with Dixon rectal cancer treated in our hospital from January 2006 to December 2010 were analyzed retrospectively to analyze the risk factors of anastomotic fistula after Dixon operation in patients with rectal cancer. Results In this group, 18 patients (10.7%) had anastomotic fistula postoperatively and 15 patients were treated with systemic nutritional support. The systemic anti-infective therapy and local intensive irrigation and drainage were used for non-surgical treatment. The other 3 cases were cured again. Conclusions The gender, age, smoking and alcohol abuse, preoperative with anemia, hypoproteinemia, diabetes and incomplete intestinal obstruction, the mass of the anal margin ≤ 5cm are the risk factors of anastomotic fistula. Early detection, early diagnosis, reasonable treatment is the key to cure anastomotic fistula.