1538例经腹全胃切除术后并发症的临床观察  

Investigation of the postoperative complications of total gastrectomy through abdominal process:analysis of 1 538 cases

作　　者：金小顺[1] 耿小平[1] 朱立新[1] 熊奇如[1] 候辉[1] 刘念[1] 王国斌[1] 

机构地区：[1]安徽医科大学第一附属医院

出　　处：《安徽医科大学学报》2008年第3期339-342,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的探讨经腹全胃切除术后并发症的发生及防治。方法回顾性分析我院1538例经腹全胃切除术的临床资料,采用Logistic多因素回归分析研究影响手术后并发症及死亡率的危险因素。结果全组患者术后并发症发生率和死亡率分别是9.49%和1.23%,D0/D1和D2/D32组的术后并发症发生率分别为10.60%和8.80%(P>0.05)。2组手术死亡率分别为1.26%和1.18%(P>0.05)。术后最常见的并发症是肺部感染(20.54%,30/146),影响手术并发症和死亡率的主要因素是肿瘤Ⅳ期、术前合并症、姑息性切除、联合脏器切除(P<0.05)。Logistic多元回归分析显示淋巴结清除范围不是影响手术并发症和死亡率的主要因素(P>0.05)。结论胃癌晚期患者手术并发症发生率高,对胃癌Ⅳ期患者行姑息性手术时应避免施行广泛性淋巴结清除及联合脏器切除术。Objective To analyze the morbidity and mortality of postoperative complication of total gastrectomy retrospectively. Methods 1 538 patients with gastric neoplasm received total gastrectomy. Postoperative morbidity and mortality were compared between two them, the risk factors influencing postoperative mortality were determined by multiple regression analysis. Results The total postoperative morbidity and mortality for all patient were 9. 49% （146/1 538） and 1.23% （19/1 538）, respectively. The postoperative complication morbidity was 10. 60% and 8.80% in the two groups（P 〉 0.05 ）, there was no significant difference between the two groups. The postoperative mortality was 1.26% and 1.18% （P 〉 0. 05 ）, there was no significant difference between the two groups. The most common postoperative complication was pulmonary infection（20.54%, 30/146）. The following clinicopathologic factors were found to be correlated with postoperative mortality ： stage IV ; palliative excision; muhivisceral resection; and preoperative complication （ P 〈 0. 05 ）. Multivariate analysis revealed that the extent of lymph node was not main risk factors influencing mortality. Conclusions Patients with advanced gastric cancer have a high risk of postoperative mortality. Unnecessary lymph node dissection or muhivisceral should be avoided for patients with stage Ⅳ gastric cancer.

关 键 词：胃肿瘤/外科学 胃切除术/方法 手术后并发症/预 防和控制 手术后并发症/死亡率 

分 类 号：R619[医药卫生—外科学] R735.2[医药卫生—临床医学]