摘要
目的研究术后第一天肠鸣音对结直肠癌手术患者围术期术后延迟性肠麻痹(PPOI)的预测价值。方法回顾性分析2019年2月~2021年2月陕西省人民医院普外二科124例确诊结直肠癌行手术治疗患者的临床资料,通过ROC曲线对患者术后第一天肠率、肠鸣音振幅、肠鸣音频率和肠鸣音持续时间与PPOI进行分析。采用单因素和多因素分析研究影响结直肠癌患者围术期PPOI发生的危险因素。结果共纳入124例患者,男性70例,女性54例。其中PPOI组患者42例,非PPOI组患者82例;通过ROC曲线分析发现术后第一天肠率和肠鸣音频率对围术期PPOI发病的预测差异有统计学意义(Z=3.300,2.159;P<0.05)。结直肠癌围术期PPOI发生的单因素分析发现,合并不全肠梗阻(OR=2.400,P=0.027)、氟尿嘧啶植入剂(OR=2.418,P=0.030),术后第一天肠率≤2.407 cpm(OR=0.287,P=0.002),术后第一天肠鸣音频率≤442.294 Hz(OR=2.805,P=0.012)是结直肠癌根治术患者围术期PPOI发生的影响因素。多因素分析结果显示,合并不全肠梗阻(OR=3.002,P=0.013)、术后第一天肠率≤2.407 cpm(OR=0.334,P=0.012)是结直肠癌根治术患者围术期PPOI的独立危险因素(P<0.05)。结论智能听诊系统监测肠鸣音对术后患者胃肠道功能恢复具有预测价值。术后第一天肠率≤2.407 cpm是结直肠癌患者围术期PPOI发生的独立危险因素。
Objective To investigate the predictive value of bowel sounds on the first postoperative day for perioperative PPOI in patients undergoing colorectal cancer surgery.Methods Retrospective analysis of 124 patients diagnosed with colorectal cancer treated surgically in the Department of General SurgeryⅡof Shaanxi Provincial People's Hospital from February 2019 to February 2021.The patients'clinical data were collected,and the first day postoperative bowel rate,bowel sound amplitude,bowel sound frequency and bowel sound duration were analyzed by ROC curve with prolong postoperative ileus(PPOI).Univariate and multifactorial analyses were used to study the risk factors for the development of postoperative PPOI in patients with colorectal cancer.Results A total of 124 patients,70 males and 54 females,were included.There were 42 patients in the PPOI group and 82 patients in the non-PPOI group.The first day postoperative bowel rate and frequency of bowel sounds were found to have predictive value for the occurrence of perioperative PPOI by ROC curve analysis(Z=3.300,2.159;P<0.05).Univariate analysis of the occurrence of perioperative PPOI in colorectal cancer found that the combination of incomplete bowel obstruction(OR=2.400,P=0.027),fluorouracil implant(OR=2.418,P=0.030),bowel rate≤2.407 cpm on the first day postoperatively(OR=0.287,P=0.002),and bowel sounds frequency≤442.294 on the first day postoperatively Hz(OR=2.805,P=0.012)were influential factors in the occurrence of perioperative PPOI in patients undergoing radical colorectal cancer surgery.The results of multifactorial analysis showed that combined incomplete bowel obstruction(OR=3.002,P=0.013)and bowel rate≤2.407 cpm on the first postoperative day(OR=0.334,P=0.012)were independent risk factors for the development of postoperative PPOI in patients undergoing radical colorectal cancer surgery(P<0.05).Conclusions Intelligent auscultation system to monitor bowel sounds has predictive value for recovery of gastrointestinal function in postoperative patients.
作者
师帅
胥博愈
陈昕
马文星
闫靓
梁雍
吴云桦
张金
刘思达
段降龙
Shuai Shi;Boyu Xu;Xin Chen;Wenxing Ma;Liang Yan;Yong Liang;Yunhua Wu;Jin Zhang;Sida Liu;Xianglong Duan(Department of General Surgery,Shaanxi Provincial People's Hospital,Xi'an 710068,China;Department of Medicine,Xi'an Jiaotong University,Xi'an 710049,China;Xi'an Engineering University College of Electronic Information,Xi'an 710072,China;Northwestern Polytechnical University Institute of Navigation,Xi'an 710048,China;Northwestern Polytechnic University Medical Research Institute,Xi'an 710072,China)
出处
《中华结直肠疾病电子杂志》
2023年第1期56-63,共8页
Chinese Journal of Colorectal Diseases(Electronic Edition)
基金
陕西省重点研发计划(2019ZDLSF02-09-01)
陕西省创新能力支撑计划(2021TD-40)
陕西省创新能力支撑计划(2019GHJD-14)。
关键词
结直肠肿瘤
肠鸣音
术后第一天肠率
术后延迟性肠麻痹(PPOI)
危险因素
Colorectal neoplasms
Bowel sounds
Intestinal rate on the first day after operation
Prolong postoperative ileus
Risk factors
