结直肠肿瘤患者术后发生代谢性酸中毒的危险因素  

Risk factors of metabolic acidosis in patients with colorectal cancer after surgery

作　　者：诸虹 孙明霞[1] 朱桂松[1] ZHU Hong;SUN Mingxia;ZHU Guisong(Intensive Care Unit,Nanjing Hospital of Traditional Chinese Medicine,Nanjing 210001,China)

机构地区：[1]南京市中医院

出　　处：《实用医学杂志》2020年第3期361-364,共4页The Journal of Practical Medicine

基　　金：南京市中医院院级课题一般项目基金资助项目(编号：YJLC201903)

摘　　要：目的讨论结直肠肿瘤患者术后发生代谢性酸中毒的危险因素,以指导临床治疗。方法回顾性分析南京市中医院2019年1月至2019年8月结直肠肿瘤手术患者105例,按术后血气分析结果是否发生代谢性酸中毒分为代谢性酸中毒组(58例)和非代谢性酸中毒组(47例),比较两组性别、年龄、体重、手术时间、术中补液、失血量等情况,采用多因素Logistic回归分析筛选结直肠肿瘤术后发生代谢性酸中毒的危险因素。结果单因素比较分析结果示,相较于非代谢性酸中毒组,代谢性酸中毒组低蛋白血症例数更多,手术时间更长,术中补液速度较低(P<0.05)。多因素Logistic回归分析显示,手术时间延长(OR=2.857,95%CI:1.247~6.548,P<0.05)、低蛋白血症(OR=6.188,95%CI:1.293~29.619,P<0.05)是结直肠肿瘤术后发生代谢性酸中毒的独立危险因素。结论手术时间延长、低蛋白血症的结直肠肿瘤患者术后易发生代谢性酸中毒。Objective To investigate the risk factors of metabolic acidosis in patients with colorectal cancer after surgery.Methods The study reviewed 105 cases of colorectal cancer patients admitted to Nanjing Hospital of Chinese Medicine from January to August 2019.According to the arterial blood gas analysis after operation,the cases were divided into acidosis group(n=58)and non⁃acidosis group(n=47).Statistical analysis was conducted for the difference of gender,age,weight,operation time,fluid input,the amount of bleeding,etc in the two groups.Then multivariate analysis was performed to investigate the risk factors.Results Univariate analysis showed that compared to non⁃acidosis group,acidosis group had more cases of hypoproteinemia,longer operation time and lower intraoperative fluid replacement rate(P<0.05).Multivariate logistic regression analysis showed that longer operation time(95%CI:1.247~6.548,P<0.05)and hypoproteinemia(95%CI:1.293~29.619,P<0.05)were independent risk factors for the occurrence of metabolic acidosis in patients with colorectal cancer after operation.Conclusion Patients with colorectal cancer with longer operation time and hypoproteinemia are prone to develop metabolic acidosis after operation.

关 键 词：结直肠肿瘤 代谢性酸中毒 低蛋白血症 危险因素 

分 类 号：R619.9[医药卫生—外科学]