腹腔镜远端胃癌根治术后胃瘫综合征的高危因素分析及对预后的影响  

High risk factors analysis of postsurgical gastroparesis syndrome and its influence on the prognosis after laparoscopic distal gastrectomy for gastric cancer

作　　者：陈昌江[1] 杨春康[1] 吴贤毅[1] 卓长华[1] 庄咏 严明芳 Chen Changjiang;Yang Chunkang;Wu Xianyi(Department of Gastrointestinal Surgery,Fujian Cancer Hospital/Affiliated Cancer Hospital of Fujian Medical University,Fuzhou 350014)

机构地区：[1]福建省肿瘤医院福建医科大学附属肿瘤医院胃肠肿瘤外科

出　　处：《中国现代医药杂志》2019年第7期17-20,共4页Modern Medicine Journal of China

摘　　要：目的分析腹腔镜远端胃癌根治术后发生胃瘫综合征(PGS)的相关危险因素及对预后的影响.方法收集2008年2月~2017年12月954例于我院行腹腔镜远端胃癌根治术患者的临床资料,回顾性分析胃瘫综合征的高危因素,并评估对预后的影响.结果所有患者中胃瘫综合征发病率为5.5%(52/954).单因素分析显示,年龄、术前白蛋白水平、术前合并焦虑症、术前存在幽门梗阻、糖尿病、术中出血量、术中吻合方式、术后镇痛方式、术后腹腔感染与胃瘫综合征发生有关(P<0.05).多因素分析显示,术前白蛋白水平、术前合并焦虑症、术前存在幽门梗阻、糖尿病、术中吻合方式、术后镇痛方式、术后腹腔感染是胃瘫综合征独立危险因素(P<0.05).胃瘫综合征患者的术后平均住院时间为(19.6±6.5)d,高于非胃瘫综合征患者的(8.0±1.2)d(P<0.05).但胃瘫综合征患者3年、5年生存率与非胃瘫综合征患者差异无统计学意义(P>0.05).结论胃瘫综合征延长患者术后住院时间,但不影响患者预后.多种因素与胃瘫综合征的发生有关,对高危患者加强围手术期管理以减少术后胃瘫综合征的发生.Objective To analyze the related risk factors for postsurgical gastroparesis syndrome(PGS)and its influence on the prognosis after laparoscopic distal gastrectomy for gastric cancer.Methods The clinical pathologic data of 954 cases who underwent laparoscopic distal gastrectomy in our hospital from Feb 2008 to Dec 2017 was enrolled.Risk factors of PGS were retrospectively analyzed and the prognosis was assessed.Results The incidence rate of PGS was 5.5%(52/954).Single factor analysis showed that PGS was significantly correlated with age,preoperative albumin level,preoperative anxiety,preoperative pyloric obstruction,diabetes,intraoperative blood loss,methods of anastomosis,postoperative analgesic method,postoperative intraabdominal infection(P<0.05).Multivariate factors analysis showed that preoperative albumin level,preoperative anxiety,preoperative pyloric obstruction,diabetes,methods of anastomosis,postoperative analgesic method,postoperative intraabdominal infection were independently associated with PGS(P<0.05).The median postoperative hospital stay was(19.6±6.5)days for PGS,longer than patients for Non-PGS with(8.0±1.2)days.There were no differences in the 3 and 5 years survival rates between them(P>0.05).Conclusion The PGS prolongs the time of hospitalization but doesn't influence the prognosis.The occurrence of PGS is affected by many factors.It is very important to strengthen perioperative management to reduce the PGS.

关 键 词：腹腔镜 胃癌根治术 胃瘫综合征 预后 

分 类 号：R735.2[医药卫生—肿瘤]