全子宫切除术后胃肠功能紊乱发生情况及其影响因素分析  

Occurrence of gastrointestinal dysfunction after total hysterectomy and its influencing factors

作　　者：张凯[1] 杨立[2] 边蓉蓉 郭迎迎 任琛琛[2] 史晓阳[3] Zhang Kai;Yang Li;Bian Rongrong;Guo Yingying;Ren Chenchen;Shi Xiaoyang(Department of Postoperative Care Unit,the Third Affiliated of Zhengzhou University,Zhengzhou 450052,China;Department of Gynecology,the Third Affiliated of Zhengzhou University,Zhengzhou,450052,China;Department of Endocrinology,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学第三附属医院术后监护室,450052 [2]郑州大学第三附属医院妇科,450052 [3]河南省人民医院内分泌科,郑州455003

出　　处：《中国实用医刊》2020年第23期5-9,共5页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(2018020204)。

摘　　要：目的观察全子宫切除术后胃肠功能紊乱的发生情况,分析胃肠功能紊乱的影响因素,旨在指导全子宫切除术后胃肠功能的早期风险评估与干预。方法抽取2016年1月至2020年7月于郑州大学第三附属医院完成全子宫切除术治疗的患者120例,设计一般资料填写表,仔细查阅患者相关资料并记录研究所需基线资料情况,全部患者术后均接受胃肠功能评估,记录患者术后胃肠功能紊乱发生情况,纳入全部可能的影响因素,经单因素与多因素分析找出全子宫切除术后胃肠功能紊乱的影响因素。结果34例患者术后发生胃肠功能紊乱,发生率为28.33%;经单项Logistic回归分析并建立多元回归模型行多因素分析检验结果显示,手术时间(长)、CO2气腹压力(高)、术后24 h白细胞计数(高)、血钾水平(低)是全子宫切除术后胃肠功能紊乱发生的影响因素(OR>1,P<0.05)。结论全子宫切除术后患者有胃肠功能紊乱风险,可能受手术时间、CO2气腹压力、术后24 h白细胞计数、血钾水平等因素影响,临床应重视有上述胃肠功能紊乱风险因素的全子宫切除术患者的早期干预,或可促进胃肠功能恢复,预防胃肠功能紊乱。Objective To observe the occurrence of gastrointestinal dysfunction after total hysterectomy,to analyze the influencing factors of gastrointestinal dysfunction,and to guide the early risk assessment and intervention of gastrointestinal function after total hysterectomy.Methods A total of 120 patients who completed total hysterectomy in the Third Affiliated Hospital of Zhengzhou University from January 2016 to July 2020 were selected.We designed a general data filling form,carefully reviewed the relevant patient data and recorded the baseline data required for the study.All patients underwent postoperative gastrointestinal function assessment.The occurrence of postoperative gastrointestinal dysfunction was recorded.And all possible influencing factors were enrolled into single factor and multiple factor analysis to find out the influencing factors of gastrointestinal dysfunction after total hysterectomy.Results Among the 120 patients,34 patients had gastrointestinal dysfunction after surgery,the incidence was 28.33%.The results of single logistic regression analysis and multiple regression model analysis showed that long operation time,high carbon dioxide(CO2)pneumoperitoneum pressure,high white blood cell count 24 h after operation and low serum potassium level were the influencing factors of gastrointestinal dysfunction after hysterectomy(OR>1,P<0.05).Conclusions Patients after total hysterectomy are at risk of gastrointestinal dysfunction,which may be affected by factors,such as operation time,CO2 pneumoperitoneum pressure,white blood cell count 24 h postoperative,and blood potassium level.Attention should be paid to the early intervention of total hysterectomy patients with the above-mentioned gastrointestinal dysfunction risk factors clinically,which may promote the recovery of gastrointestinal function and prevent gastrointestinal dysfunction.

关 键 词：子宫切除术 胃肠功能紊乱 CO2气腹压力 白细胞计数 

分 类 号：R713.44[医药卫生—妇产科学]