胃代食管手术术后吻合口瘘发生的危险因素分析
Analysis of Risk Factors for Anastomotic Fistula Formation following Gastric-Esophageal Substitution Surgery
摘要: 目的：探究胃代食管手术患者术后吻合口瘘发生情况，并分析其发生的危险因素。方法：回顾性分析了2017~2023年青岛大学附属医院100例行胃代食管手术病例的临床资料，根据患者术后发生吻合口瘘情况分为吻合口瘘组和非吻合口瘘组。采用单因素分析及二元Logistic回归分析患者术后发生吻合口瘘的危险因素。结果：100例胃代食管手术患者术后有17例出现吻合口瘘，发生率为17%。单因素分析结果显示，术后瘘前肺炎的发生、冠状动脉硬化性心脏病、术后输血、术前放疗差异有统计学意义(P < 0.05)，二元Logistic回归分析显示，术后瘘前肺炎为胃代食管手术后发生吻合口瘘的独立危险因素(P < 0.05)。结论：术后瘘前肺炎的发生、冠状动脉硬化性心脏病、术后输血、术前放疗与患者术后吻合口瘘的发生有关，术后瘘前肺炎为胃代食管手术后发生吻合口瘘的独立危险因素。临床须针对上述高危因素制定针对性的防治措施，以降低吻合口瘘的发生率。
Abstract: Objective: To investigate the incidence of anastomotic fistula in patients undergoing gastric-esophageal replacement surgery and analyze its risk factors. Methods: Clinical data from 100 patients undergoing gastro-esophageal bypass surgery at The Affiliated Hospital of Qingdao University between 2017 and 2023 were retrospectively analyzed. Patients were categorized into anastomotic fistula group and non-fistula group based on postoperative occurrence. Univariate analysis and binary Logistic regression were employed to identify risk factors for anastomotic fistula formation. Results: Among 100 patients undergoing gastric-esophageal replacement surgery, 17 developed anastomotic fistula postoperatively, yielding an incidence rate of 17%. Univariate analysis revealed statistically significant differences in postoperative pulmonary infection, coronary atherosclerotic heart disease, postoperative blood transfusion, and preoperative radiotherapy (P < 0.05). Binary Logistic regression analysis identified postoperative pulmonary infection as an independent risk factor for anastomotic fistula after gastric-esophageal bypass surgery (P < 0.05). Conclusion: Postoperative pulmonary infection, coronary atherosclerotic heart disease, postoperative blood transfusion, and preoperative radiotherapy are associated with anastomotic fistula formation after gastric-esophageal bypass surgery. Postoperative pulmonary infection is an independent risk factor for anastomotic fistula after gastric-esophageal bypass surgery. Clinicians should implement targeted prevention and control measures for these high-risk factors to reduce the incidence of anastomotic fistula.
文章引用：郭烨锟, 庞文会, 赖小龙, 王小雅, 邱杰. 胃代食管手术术后吻合口瘘发生的危险因素分析[J]. 临床医学进展, 2026, 16(2): 511-519. https://doi.org/10.12677/acm.2026.162420

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