摘要
目的探讨胃癌患者远端胃大部切除术后胃瘫综合征的相关因素以及不同治疗方案的疗效。方法采用单因素分析方法和非条件多因素Logistic回归分析41例术后胃瘫综合征(PGS)患者和719例无PGS患者的影响因素。结果 PGS患者和无PGS患者在手术方式、消化道重建方式、幽门梗阻、腹腔感染、术后高血糖、术后低蛋白、术后贫血、术后营养方式、手术时间、出血量方面比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,毕Ⅱ式消化道重建、腹腔感染、术后高血糖、术后贫血、术后低蛋白、手术时间长、出血量多为PGS的危险因素(OR>1,P<0.05),腔镜手术是胃瘫的保护因素(OR<1,P<0.05)。联合药物治疗恢复时间显著优于单药(P<0.05)。PGS组住院时间、住院花费均显著高于非PGS组(P<0.05)。结论围术期避免上述危险因素可预防胃瘫发生,联合用药可加快胃瘫恢复。
Objective To investigate the related factors of gastroparesis syndrome after radical distal gastrectomy and the curative effect of different treatment regimens.Methods Univariate analysis and unconditional multivariate Logistic regression analysis were used to analyze the influencing factors in 41 patients with postsurgical gastroparesis syndrome(PGS)and 719 patients without PGS.Results There were significant differences in surgical methods,gastrointestinal reconstruction,pyloric obstruction,abdominal infection,postoperative hyperglycemia,postoperative low protein,postoperative anemia,postoperative nutrition,operation time and bleeding volume between PGS patients and non-PGS patients(P<0.05).Multivariate Logistic regression analysis showed that patients with Billroth-Ⅱgastrointestinal reconstruction,abdominal infection,postoperative hyperglycemia,postoperative anemia,postoperative low protein,prolonged operation,and bleeding were risk factors for PGS(OR>1,P<0.05).Laparoscopic surgery was the protective factor of gastroparesis(OR<1,P<0.05).The recovery time of combined drug therapy was significantly better than that of single drug(P<0.05).The length of hospital stay and hospitalization expense in PGS group were significantly higher than non-PGS group.Conclusion Avoidance of the above risk factors in perioperative period can prevent the occurrence of gastroparesis.Combined treatment can accelerate the recovery of gastroparesis.
作者
张强
侯栋升
姚立彬
李超
王辉
孟松
洪健
邵永
朱孝成
ZHANG Qiang;HOU Dongsheng;YAO Libin;LI Chao;WANG Hui;MENG Song;HONG Jian;SHAO Yong;ZHU Xiaocheng(Department of Gastroenterological Surgery,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,221000)
出处
《实用临床医药杂志》
CAS
2018年第7期53-56,共4页
Journal of Clinical Medicine in Practice
