胃癌手术后胃瘫综合征的多因素分析  

Risk factors for postsurgical gastroparesis syndrome after operaton for gastric cancer

作　　者：廖有祥[1] 汤恢焕[1] 刘庆武[2] 肖广发[1] 魏伟[1] 霍胜军[1] 胡国璜[1] 

机构地区：[1]中南大学湘雅医院普通外科 [2]中南大学公共卫生学院,湖南长沙410008

出　　处：《中国普通外科杂志》2008年第4期318-321,共4页China Journal of General Surgery

摘　　要：目的探讨胃癌手术后发生胃瘫的危险因素。方法回顾性分析6年手术治疗的486例胃癌患者的临床资料。以与发生胃瘫有关的因素为变量组单因素及多因素非条件行回归分析。结果486例中发生胃瘫43例(8.85%)。单因素及多因素分析显示,与胃瘫发生有关有5个因素,即术前出现幽门梗阻,B-Ⅱ式远端胃癌根治性胃大部分切除,术后腹腔感染,术后高血糖水平和围手术期低清(白)(≤30g/L)蛋白血症;而血清蛋白>30g/L是预防胃癌术后发生PGS的保护因素。结论胃癌手术后发生胃瘫的原因是多因素的,作好围手术期处理对预防术后胃瘫的发生有重要的作用。Objective To study the risk factors of postoperative gastroparesis syndrome （ PGS ） after operaton for gastric cancer. Methods The clinical data of 486 gastric cancer cases who underwent operation during recent 6 years were analyzed with binary logistic regression. Results There were 43 （8. 85 % ） cases of PGS after operation for gastric cancer. Among11 factors, 5 factors were proved to be risk factors for PGS after operaton by analysis of single and multiple variables. Those were preoperative pyloric obstruction, distal radical subtotal gastrectomy, postoperative hyperglycemia, postoperative abdominal cavity infection and hypoproteinemia in perioperative period. Serum albumin level 〉 30 g/L was protective factors for prevention of PGS after operation for gastric cancer. Conclusions PGS is affected by many factors after operation for gastric cancer. It is important to pay attention to perioperative management in preventing the onset of PGS.

关 键 词：胃肿瘤/外科学 胃瘫/并发症 胃瘫/危险因素 

分 类 号：R735.2[医药卫生—肿瘤]