胃癌根治术后发生功能性胃排空障碍的影响因素分析  

An analysis of factors influencing the occurrence of functional delayed gastric emptying after radical gastrectomy

作　　者：陆丽红 杨小毛[1] 吴辰[1] 魏云海[1] LU Lihong;YANG Xiaomao;WU Chen(Department of Gastroenterology,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]湖州市中心医院(湖州师范学院附属中心医院)肠胃外科,浙江313000

出　　处：《江苏医药》2021年第5期459-462,共4页Jiangsu Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019ZD050)。

摘　　要：目的探讨胃癌根治术后发生功能性胃排空障碍(FDGE)的影响因素。方法 158例接受胃癌根治术治疗的患者中,106例患者术后未发生FDGE,52例患者发生FDGE。采用多因素logistic回归分析胃癌术后发生FDGE的影响因素。构建列线图模型,计算一致性指数,并应用R软件绘制FDGE风险预测列线图。结果多因素logistic回归分析显示,术前有胃潴留、围术期白蛋白≤30 g/L、BillrothⅡ式、未保留迷走神经干、术后FBG>8 mmol/L、有腹腔并发症、焦虑情绪和糖尿病病史均是胃癌术后发生FDGE的独立危险因素(P<0.05)。FDGE发生的风险预测模型的一致性指数为0.765[95%CI(0.649~0.824)],表明构建的FDGE风险模型的真实性、可靠性和准确性较高。结论胃癌根治术后患者发生FDGE与术后高血糖、围术期低白蛋白、术前有胃潴留、BillrothⅡ式、未保留迷走神经干、腹腔并发症及焦虑情绪等因素密切相关;减少患者术前胃潴留,减轻患者的焦虑状态有助于预防FDGE的发生。Objective To analyze the factors influencing the occurrence of functional delayed gastric emptying(FDGE) after radical gastrectomy.Methods Of 158 patients underwent radical gastrectomy for gastric cancer, FDGE occurred in 52 cases.Multivariate logistic analysis was used to analyze the factors influencing the occurrence of FDGE in the patients with gastric cancer after radical gastrectomy.The Nomogram model was constructed to calculate the consistency index, and the nomogram of risk prediction was drewn with R software.Results Multivariate logistic analysis showed that the risk factors for the occurrence of FDGE after radical gastrectomy included preoperative gastric retention, perioperative albumin≤30 g/L,BillrothⅡ anastomosis, unreserved vagal nerve trunk, postoperative FBG>8 mmol/L,abdominal complications, anxiety and diabetes mellitus history(P<0.05).The consistency index of the risk model for predicting the occurrence of FDGE was 0.765 [95% CI(0.649-0.824)],which indicated that the model had higher validity, reliability and accuracy.Conclusion The occurrence of FDGE in the patients with gastric cancer after radical gastrectomy is closely related to the postoperative hyperglycemia, perioperative hypoalbuminemia, preoperative gastric retention, BillrothⅡ anastomosis, unreserved vagal nerve trunk, abdominal complications and anxiety.A decrease of the preoperative gastric retention and anxiety state of the patients will help to prevent the occurrence of FDGE after radical gastrectomy for gastric cancer.

关 键 词：胃癌 功能性胃排空障碍 影响因素 列线图模型 

分 类 号：R735[医药卫生—肿瘤]