【摘要】 目的探讨术前糖化血红蛋白(HbA_1c)水平与老年结直肠癌伴2型糖尿病患者术后吻合口瘘的相关性。方法选取2011年6月-2017年6月本院收治的126例老年结直肠癌伴2型糖尿病患者,以HbA_1c值> 6. 3%为观察组（n=67）,HbA_1c值≤6. 3%为对照组（n=59）。比较2组患者的一般资料和术后吻合口瘘发生率,并分析术后吻合口瘘的相关危险因素。结果与对照组比较,观察组年龄及病程更大、更长（P <0. 05）;观察组术后吻合口瘘发生率高于对照组,差异有统计学意义（P <0. 05）。单因素分析显示,术后吻合口瘘与体质量指数、术前HbA_1c、手术时间、肿瘤部位与TNM分期有关（P <0. 05）。多因素分析显示,术前HbA_1c> 6. 3%和直肠癌是术后吻合口瘘的独立危险因素（P <0. 05）。结论术前高水平的HbA_1c会增加老年结直肠癌伴2型糖尿病患者术后吻合口瘘发生率。更多还原

【Abstract】 Objective To investigate the association of postoperative anastomotic leak with preoperative level of HbA_{1 c}in elderly patients with colorectal cancer and type 2 diabetes mellitus. Methods A total of 126 elderly patients with colorectal cancer and type 2 diabetes mellitus from June 2011 to June 2017 were reviewed. They were divided into observation group( HbA_{1 c}>6. 3%,n = 67) and control group( HbA_{1 c}≤6. 3%,n =59). The general data and incidence of postoperative anastomotic leak between the two groups were compared,and risk factors of anastomotic leak were analyzed. Results Compared with the control group,the age and course of diabetes mellitus in the observed group were older or longer（ P < 0. 05）. The incidence of postoperative anastomotic leak in the observation group was higher than that in the control group,with the differences statistically significant（ P < 0. 05）. Univariate analysis identified the following risk factors as BMI,preoperative level of HbA_{1 c},operation time,tumor location and TNM classification（ P < 0. 05）. Multifactor regression analysis revealed that HbA_{1 c}> 6. 3% and rectal cancer were independent risk factors for anastomotic fistula（ P < 0. 05）. Conclusion Preoperative high level of HbA_{1 c}increases the incidence of anastomotic leak of elderly patients with colorectal cancer and type 2 diabetes mellitus.更多还原