腹腔镜下毕Ⅱ胃癌根治术后并发空肠梗阻等并发症的危险因素分析与处理

发布时间：2019-03-18 12:48

【摘要】：目的分析腹腔镜下毕Ⅱ胃癌根治术后空肠梗阻等并发症的危险因素及处理方法。方法对117例胃癌患者手术治疗前后的临床资料进行分析,并对术后发生并发症可能的危险因素进行评估。结果腹腔镜下毕Ⅱ胃癌根治术后并发症包括切口感染、肺部感染或胸腔积液、腹腔感染和空肠梗阻吻合口瘘,发生率为35.04%(41/117),手术方式、手术时间、胃管留置时间、术后生活习惯与手术后并发症相关。结论腹腔镜下毕Ⅱ胃癌根治术后并发症由多种原因综合引起,除患者素质和病变因素外,6个危险因素依次为:行全胃切除术、手术时间4 h、术中出血量800 ml、胃管留置时间3 d、长期吸烟以及胸腹联合切口,应重视其围手术期处理。其中胃管留置时间3 d、胸腹联合切口、长期吸烟以及手术时间4 h进行回归方程,为术后并发症主要危险因素。
[Abstract]:Objective to analyze the risk factors and management of complications such as jejunal obstruction after radical resection of gastric cancer by laparoscopy. Methods the clinical data of 117 patients with gastric cancer before and after operation were analyzed and the possible risk factors of postoperative complications were evaluated. Results the complications of laparoscopic radical gastrectomy included incision infection, pulmonary infection or pleural effusion, abdominal infection and jejunal obstruction anastomotic fistula, the incidence was 35.04% (41 / 117), the operation mode and operation time were 35. 04% (41 / 117). Gastric tube indwelling time and postoperative life habits were related to postoperative complications. Conclusion the complications after radical resection of gastric cancer under laparoscopy are caused by multiple causes. In addition to the patients' quality and pathological factors, the six risk factors are: total gastrectomy, operation time of 4 hours, intraoperative bleeding volume of 800 ml,. The peri-operative management of gastric tube indwelling time 3 days, long-term smoking and thoraco-abdominal incision should be emphasized. The regression equation of gastric tube indwelling time 3 days, chest-abdomen incision, long-term smoking and operation time 4 h were the main risk factors of postoperative complications.
【作者单位】：甘肃医学院第一附属医院(甘肃省平凉市医院)普外科;
【分类号】：R735.2

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