根治性远端胃大部切除术后胃瘫综合征的回顾性研究及危险因素分析

发布时间：2019-02-13 02:50

【摘要】：目的:回顾性研究根治性远端胃大部切除术后胃瘫综合征及术后正常对照组的患者病历资料,找出可能诱发PGS的危险因素,以期降低胃癌根治术后残胃胃瘫的发生率。方法:查阅2007年1月到2016年12月收治山西省人民医院普通外科的根治性远端胃大部切除术患者的病历资料,对符合标准的335例病例进行相关数据资料统计。根据是否发生PGS分病例组和对照组,应用统计软件分析两组患者在一般资料、术前、手术及术后因素等方面的差异,找出可能与PGS有关的因素;对差异有统计学意义的因素再进行Logistic多因素回归分析。结果:335例入选病例中有23例发生PGS,发病率6.87%。单因素分析结果提示低体重指数(≤18.5kg/m2)、术前低白蛋白血症(30g/L)、围手术期高血糖(8.0mmol/L)、术前幽门梗阻、吻合方式(Billroth II或胃空肠Roux-en-Y式)及术后腹腔并发症与根治性远端胃大部切除术后胃瘫相关,差异有统计学意义(P0.05)。Logistic多因素回归分析发现术前低白蛋白血症(P=0.012)、围手术期高血糖(P=0.009)、术前幽门梗阻(P=0.030)、吻合方式(Billroth II或胃空肠Roux-en-Y式)(P=0.045)及术后腹腔并发症(P=0.036)是PGS的独立危险因素。结论:PGS与多因素相关,术前纠正低蛋白血症、围手术期控制血糖、术前幽门梗阻患者充分胃肠减压、洗胃、Billroth I式吻合以及预防腹腔并发症,可能降低并减少PGS的发生。
[Abstract]:Objective: to study retrospectively the medical records of patients with gastroparesis syndrome after radical distal gastrectomy and postoperative normal control group, and to find out the risk factors of inducing PGS in order to reduce the incidence of residual gastroparesis after radical gastrectomy. Methods: the medical records of 335 patients with radical distal subtotal gastrectomy admitted to Shanxi Provincial people's Hospital from January 2007 to December 2016 were reviewed. According to whether the occurrence of PGS was divided into case group and control group, statistical software was used to analyze the differences in general data, preoperative, operative and postoperative factors between the two groups, and to find out the possible factors related to PGS. Logistic multivariate regression analysis was performed on the statistically significant factors. Results: the incidence of PGS, was 6.87 in 23 out of 335 selected cases. Univariate analysis showed that low body mass index (鈮，

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