摘要
目的探究结直肠癌患者围手术期的贫血发生率及术前贫血的影响因素。方法回顾性分析2019年1月1日至2019年12月31日期间于华中科技大学同济医学院附属协和医院胃肠外科住院接受手术治疗的1 250例结直肠癌患者的临床病理资料。根据术前血红蛋白水平分为贫血组和非贫血组,采用单因素分析方法和多因素logistic回归分析探究结直肠癌患者术前贫血的影响因素,并分析术前贫血对患者术中输血、术后并发症及术后住院时间的影响。结果结直肠癌患者的术前贫血发生率为40.6%(508/1 250),其中右半结肠癌、左半结肠癌和直肠癌患者的术前贫血发生率分别为66.0%(192/291)、41.1%(139/338)和28.5%(177/621)。结直肠癌患者的术后贫血发生率为69.4%(867/1 250),其中右半结肠癌、左半结肠癌和直肠癌患者的术后贫血发生率分别为81.8%(238/291)、68.9%(233/338)和63.8%(396/621)。多因素logistic回归分析结果显示,年龄>60岁、营养风险筛查2002评分≥3分、右半结肠癌、T3-4期和M1期是结直肠癌患者术前贫血的危险因素(P<0.05)。结直肠癌术前贫血组患者的术中输血率及术后并发症发生率高于非贫血组(P<0.05),结肠癌术前贫血组患者的术后住院时间长于非贫血组(P<0.05)。结论结直肠癌患者的围手术期贫血发生率较高。高龄、营养风险高、右半结肠癌、T3-4期及肿瘤远处转移是结直肠癌患者术前贫血的危险因素。术前贫血可增加结直肠癌患者术中输血需求和术后并发症发生率,延长结肠癌患者的术后住院时间。
Objective To investigate the incidence of perioperative anemia and the influencing factors of preoperative anemia in patients with colorectal cancer.Methods The clinicopathological data of 1250 patients with colorectal cancer who underwent surgery in our hospital from January 1,2019 to December 31,2019 were analyzed retrospectively.According to the preoperative hemoglobin level,patients were divided into anemia group and non-anemia group.Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors of preoperative anemia in patients with colorectal cancer,and the effects of preoperative anemia on intraoperative blood transfusion,postoperative complications,and postoperative hospital stay were analyzed.Results The incidence of preoperative anemia in patients with colorectal cancer was 40.6%(508/1250),and the incidence of preoperative anemia in patients with right colon cancer,left colon cancer,and rectal cancer was 66.0%(192/291),41.1%(139/338),and 28.5%(177/621),respectively.The incidence of postoperative anemia in patients with colorectal cancer was 69.4%(867/1250),and the incidence of postoperative anemia in patients with right colon cancer,left colon cancer,and rectal cancer was81.8%(238/291),68.9%(233/338),and 63.8%(396/621),respectively.Multivariate logistic regression analysis showed that age>60 years old,nutritional risk screening 2002≥3,right colon cancer,T3–4 stage,and M1 stage were risk factors for preoperative anemia in patients with colorectal cancer(P<0.05).The rate of intraoperative blood transfusion and the incidence of postoperative complications in the preoperative anemia group of patients with colorectal cancer were higher than those in the non-anemia group(P<0.05).The postoperative hospital stay in the preoperative anemia group of patients with colon cancer was longer than that in the non-anemia group(P<0.05).Conclusions The incidence of perioperative anemia in patients with colorectal cancer is high.Advanced age,high nutritional risk,right colon cancer,T3–4 stage,and distant metastasis were the risk factors of preoperative anemia in patients with colorectal cancer.Preoperative anemia can increase the demand for intraoperative blood transfusion and the incidence of postoperative complications in patients with colorectal cancer,and prolong postoperative hospital stay of colon cancer patients.
作者
童昕
孙雄
蒋祈
曾祥宇
尹玉平
刘炜圳
张鹏
王征
龙跃平
高金波
蔡开琳
王国斌
陶凯雄
TONG Xin;SUN Xiong;JIANG Qi;ZENG Xiangyu;YIN Yuping;LIU Weizhen;ZHANG Peng;WANG Zheng;LONG Yueping;GAO Jinbo;CAI Kailin;WANG Guobin;TAO Kaixiong(Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2021年第8期1003-1008,共6页
Chinese Journal of Bases and Clinics In General Surgery
基金
国家自然科学基金(项目编号:81702386、81874184、82072736)。
关键词
结直肠癌
贫血
围手术期
发生率
影响因素
colorectal cancer
anemia
perioperative period
incidence
influencing factor
作者简介
通信作者:陶凯雄,Email:kaixiongtao@hust.edu.cn。
