摘要
目的 探讨腹腔镜胰十二指肠切除术后胃瘫的危险因素,为临床预防提供参考依据.方法 回顾性分析我院2013年8月至2016年12月施行的90例腹腔镜胰十二指肠切除手术患者的临床资料,其中男57例（63.3%）,平均年龄54.6岁.20例术后出现胃瘫,发病率为22.2%.选取围手术期31个独立变量进行单因素分析及Logistic回归分析,筛选出与腹腔镜胰十二指肠切除术后胃瘫相关的危险因素.结果 单因素分析结果显示,营养不良、低蛋白血症、贫血、保留幽门、广泛淋巴清扫、焦虑、术前高血糖、肠内营养延迟、腹腔感染、术后高血糖等10个变量与术后胃瘫有关（OR值分别为3.143、3.587、2.852、2.889、3.231、7.071、2.889、5.359、6.000、6.263,P均〈0.05）.Logistic回归分析结果显示广泛淋巴清扫、焦虑、保留幽门、腹腔感染、肠内营养延迟、低蛋白血症、术后高血糖等7个变量是腹腔镜胰十二指肠切除术后胃瘫的危险因素（OR值分别为17.574、8.931、6.637、6.461、6.446、5.414、5.200,P均〈0.05）.结论 多种因素可以导致腹腔镜胰十二指肠切除术后胃瘫,围手术期应针对相关危险因素进行干预预防.
Objective To investigate the risk factors associated with gastroparesis syndrome after laparoscopic pancreatoduodenectomy which provide reference for clinical prevention.Methods Ninety cases of laparoscopic pancreatoduodenectomy admitted from August 2013 to December 2016 in Traditional Chinese Medicine Hospital of Guangdong Province were studied retrospectively,57 were male（63.3%）,the average age was 54.6 years old.Twenty cases were diagnosed postoparative gastroparesis syndrome（22.2%）.To screen out the risk factors,31 independent variables were analyzed by univariate analysis and logistic regression.Results Univariate analysis showed that malnutrition,hypoproteinemia,anemia,pylorus-preserving,extensive lymph nodes dissection,anxiety,high blood sugar before operation,delay of enteral nutrition,abdominal infection and postoperative high blood sugar were associated with postoperative gastroparesis（The value of OR were 3.143,3.587,2.852,2.889,3.231,7.071,2.889,5.359,6.000,6.263,P〈0.05）.Multivariate Logistic regression analysis showed that extensive lymph nodes dissection,anxiety,pylorus-preserving,abdominal infection,delay of enteral nutrition,hypoproteinemia,postoperative high blood sugar were risk factors of postoperative gastroparesis（The value of OR were 17.574,8.931,6.637,6.461,6.446,5.414,5.200;P〈0.05）.Conclusion Multiple risk factors can lead to gastroparesis after laparoscopic pancreatoduodenectomy,measures should be taken aimed at these risk factors during perioperative period.
作者
郑志鹏
何军明
钟小生
黄有星
刁竞芳
彭建新
谭志健
Zheng Zhipeng He Junming Zhong Xiaosheng Huang Youxing Diao Jingfang Peng Jianxin Tan Zhijian(Hepatobiliary and Pancreatic Surgery Department, Traditional Chinese Medicine Hospital of Guangdong Province, Guangzhou 510120, China)
出处
《中国综合临床》
2017年第4期300-303,共4页
Clinical Medicine of China
基金
广东省科技计划项目（20138022000089）
