胃癌术后胃瘫综合征的临床危险因素分析  

GASTROPARESIS SYNDROM AFTER SURGERY FOR GASTRIC CANCER: AN ANALYSIS OF CLINICAL RSIK FACTORS

作　　者：王振波[1] 张建立[1] 江秀丽[1] 

机构地区：[1]青岛大学医学院附属医院东区普外科,山东青岛266061

出　　处：《齐鲁医学杂志》2012年第1期14-16,共3页Medical Journal of Qilu

摘　　要：目的探讨胃癌手术后发生胃瘫综合征(PGS)的危险因素。方法回顾性分析我院近6年手术治疗756例胃癌病人(不包括行全胃切除术病人)的临床资料,对可能影响PGS发生的因素进行单因素分析与Logistic回归分析。结果 756例中发生PGS者46例(6.02%)。单因素分析显示,与PGS发生有关的因素分别为年龄≥65岁、毕-Ⅱ式胃癌根治术、术前幽门梗阻、围手术期高糖血症(≥8.0mmol/L)、围手术期低清蛋白血症(≤30g/L)(χ2=6.260～19.249,P<0.05);多因素Logistic回归分析显示,与PGS发生有关的因素有4个,即毕-Ⅱ式胃癌根治术、术前幽门梗阻、围手术期高糖血症、围手术期低清蛋白血症(OR=1.075～12.503,P<0.05)。结论毕-Ⅱ式胃癌根治术、术前出现幽门梗阻、围手术期高糖血症、围手术期低清蛋白血症是胃癌术后PGS发生的高危因素,做好围手术期处理对预防PGS的发生有重要意义。Objective To analyze risk factors of postgastrectomy gastroparesis syndrome（PGS）.Methods A retrospective study was done for clinical data of 756 patients with gastric cancer received gastrectomy（total gastrectomy was not inclu-ded） in recent six years,the possible factors contributing to PGS were studied by single-factor analysis and logistic regression ana-lysis.Results Of those 756 cases analyzed,46（6.02%） developed PGS.Single-factor analysis showed that PGS-related factors included old age,Billroth Ⅱ operation,preoperative pyloric obstruction,perioperative hyperglycemia（≥8.0 mmol/L） and hypoalbuminemia（≤30 g/L）（χ2=6.260-19.249,P0.05）;Logistic regression analysis indicated there were four factors associa-ted with the occurrence of PGS： Billroth Ⅱ radical gastrectomy,preoperative pyloric obstruction,perioperative hyperglycemia and hypoproteinemia（OR=1.075-12.503,P0.05）.Conclusion Billroth Ⅱ operation,preoperative pyloric obstruction,perio-perative hyperglycemia and hypoproteinemia are the high risk factors of PGS.A perioperative management is important in the prevention of PGS.

关 键 词：胃肿瘤 胃切除术 胃瘫综合征 危险困素 回归分析 

分 类 号：R619.9[医药卫生—外科学]