胃肠道腹腔镜手术后发生高淀粉酶血症的危险因素分析  

Analysis of the value and risk factors of hyperamylasemia after laparoscopic gastrointestinal surgery

作　　者：侯佩国 马振刚 刘凤军[2] HOU Pei-guo;MA Zhen-gang;LIU Feng-jun(Department of General Surgery, Ji" nan Shanghe County People'sHospital, Ji'nan 251600, China)

机构地区：[1]济南商河县人民医院普外科,251600 [2]山东大学齐鲁医院胃肠外科,250012

出　　处：《中国实用医药》2019年第12期6-8,共3页China Practical Medicine

摘　　要：目的分析胃肠道腹腔镜手术后发生高淀粉酶血症的危险因素。方法 120例胃肠道肿瘤行腹腔镜手术的患者,根据其术后是否发生高淀粉酶血症分为高淀粉酶血症组和对照组,各60例。以单因素与Logistic多因素分析高淀粉酶血症发生的危险因素。结果高淀粉酶血症组患者血清淀粉酶水平术后3 d恢复正常45例、术后5 d恢复正常10例、术后7 d恢复正常5例。高淀粉酶血症组并发症发生率25.00%明显高于对照组的6.67%,差异有统计学意义(P<0.05)。高淀粉酶血症组手术时间(175.2±1.6)min、气腹时间(115.2±2.9)min长于对照组的(160.5±2.2)、(102.5±2.6)min,失血量(212.5±3.8)ml多于对照组的(185.6±1.9)ml,体质量指数(BMI)>25 kg/m2占比58.33%、术中处理胰腺操作占比46.67%、上腹部手术占比61.67%均明显高于对照组的36.67%、28.33%、43.33%,差异有统计学意义(P<0.05)。多因素回归分析结果表明手术时间、上腹部手术、气腹时间、术中处理胰腺操作是高淀粉酶血症发生的高危因素(P<0.05)。结论胃肠道腹腔镜手术后发生高淀粉酶血症的危险因素比较复杂,手术时间、气腹时间、失血量、上腹部手术、术中处理胰腺操作是其高危因素,临床手术治疗期间要提高警惕。Objective To analyze the risk factors of hyperamylasemia after laparoscopic gastrointestinal surgery. Methods A total of 120 patients with gastrointestinal tumors undergoing laparoscopic surgery were divided into hyperamylasemia group and control group according to the occurrence of hyperamylasemia after operation, with 60 cases in each group. Risk factors of hyperamylasemia was analyzed by single factor and logistic multifactor analysis. Results In hyperamylasemia group, serum amylase level returned to normal 3 d after operation in 45 cases, 5 d after operation in 10 cases, and 7 d after operation in 5 cases. The hyperamylasemia group had higher incidence of complications as 25.00% than 6.67% in control group, and the difference was statistically significant(P<0.05). The hyperamylasemia group had longer operation time as(175.2±1.6) min and pneumoperitoneum time as(115.2±2.9) min than(160.5±2.2) and(102.5±2.6) min in the control group, more blood loss as(212.5±3.8) ml than(185.6±1.9) ml in the control group, and obviously higher proportion of body mass index(BMI)>25 kg/m2 as 58.33%, proportion of intraoperative management of pancreas as 46.67% and proportion of upper abdominal surgery as 61.67% than 36.67%, 28.33% and 43.33% in the control group. Their difference was statistically significant(P<0.05). Multivariate regression analysis showed that operation time, upper abdominal surgery, pneumoperitoneum time and operation of intraoperative management of pancreas were high risk factors for hyperamylasemia(P<0.05). Conclusion The risk factors for hyperamylasemia after laparoscopic gastrointestinal surgery are complicated. The operation time, pneumoperitoneum time, blood loss, upper abdominal surgery, and intraoperative pancreatic operation are high risk factors. Clinical workers should be vigilant during clinical operation.

关 键 词：胃肠道腹腔镜手术 高淀粉酶血症 危险因素 

分 类 号：R656[医药卫生—外科学]