【摘要】 目的探讨结直肠切除术后发生吻合口瘘的危险因素。方法通过计算机检索PubMed、Medline、Embase及Google scholar英文数据库,收集2013年1月—2018年1月关于结直肠手术后出现吻合口瘘相关危险因素的相关研究。采用RevMan 5.3软件对数据进行Meta分析,纽卡斯尔渥太华量表(NOS)进行文献质量评价,同时评估异质性和发表偏倚。结果共检索出相关文献2882篇,最终经过质量评估筛选出符合纳入文献12篇,总计64 475例患者。其中,3152例(4.9%)发生了吻合口瘘。可能是吻合口瘘的危险因素包括:男性[OR=1.52, 95%CI(1.11～2.07)]、美国麻醉医师协会(ASA)分级≥Ⅲ级[OR=1.44,95%CI(1.33～1.56)]、急诊手术[OR=1.52,95%CI(1.37～1.69)]和吸烟史[OR=1.73,95%CI(1.54～1.94)]。结论男性、ASA分级≥Ⅲ级、急诊手术和吸烟史是结直肠术后吻合口瘘发生的危险因素,认识这些危险因素可影响疾病治疗的决策,降低结直肠术后吻合口瘘的发生率。更多还原

【Abstract】 Objective To explore the risk factors for anastomotic leakage after colorectal resection.Methods The related studies of the risk factors for anastomotic leakage after colorectal surgery published during January 2013 to January 2018 were collected by searching from PubMed,Medline,Embase and Google scholar English databases.A Meta-analysis of the data was performed using RevMan 5.3 software,the Newcastle Ottawa Scale(NOS) was evaluated for bias,and the GRADE method was used to evaluate the quality of the results.Results A total of 2882 related articles was retrieved,of which 12 articles(64 475 cases) were eligible for inclusion after quality assessment.Of 64 475 cases,3152(4.9%) patients had anastomotic leakage.The possible risk factor for anastomotic leakage after colorectal resection were male [OR=1.52, 95%CI(1.11-2.07)],ASA grade≥Ⅲ[OR=1.44,95%CI(1.33-1.56)],emergency surgery [OR=1.52,95%CI(1.37-1.69)] and smoking history [OR=1.73,95%CI(1.54-1.94)].Conclusion The possible risk factor for anastomotic leakage after colorectal resection are male,ASA grade≥Ⅲ,emergency surgery and smoking history.Understanding these risk factors may influence the decision making in the treatment and reduce the incidence of anastomotic leakage.更多还原