胃癌术后并发症发生情况及危险因素分析  

Research of postoperative complications and the risk factors for gastric cancer

作　　者：刘福全[1] 常莹 张狄康 宋芳华[4] LIU Fu-quan;CHANG Ying;ZHANG Di-kang;SONG Fang-hua(The Third Ward of the Anorectal,Xinhua Hospital Affiliated to Dalian University,Liaoning Province,Dalian116021,China;Department of Oncology,Joint Logistic Support Force of PLA No.967 Hospital,Liaoning Province,Dalian116083,China;Image Center,Dalian Third People′s Hospital,Liaoning Province,Dalian116091,China;The Second Ward of the Oncology Department,Xinhua Hospital Affiliated to Dalian University,Liaoning Province,Dalian116021,China)

机构地区：[1]大连大学附属新华医院肛肠科三病房,辽宁大连116021 [2]解放军联勤保障部队第九六七医院肿瘤内科,辽宁大连116083 [3]大连市第三人民医院影像中心,辽宁大连116091 [4]大连大学附属新华医院肿瘤二病房,辽宁大连116021

出　　处：《中国当代医药》2021年第34期191-195,共5页China Modern Medicine

基　　金：辽宁省大连市卫生局课题项目(2015-110)。

摘　　要：目的探讨胃癌术后并发症的发生情况及危险因素。方法回顾性分析2010年1月至2020年5月大连大学附属新华医院、大连市第三人民医院与解放军联勤保障部队第九六七医院收治的508例胃癌术后患者的临床资料,根据是否发生术后并发症,将其分为并发症组(n=71)与非并发症组(n=437)。将单因素分析中并发症组与无并发症组存在显著差异的因素纳入多因素logistic回归分析,分析其是否为相关危险因素。结果508例胃癌术后患者中71例出现术后并发症,术后并发症发生率为13.98%,其中以切口感染及肺部感染发生率最高,分别为2.36%和1.77%。单因素分析结果显示,发病年龄、术前合并症、预后营养指数、手术范围及手术经验是术后并发症发生的相关因素(P<0.05)。多因素分析结果显示,术前合并症、预后营养指数为术后并发症发生的危险因素(OR=3.12、3.48;95%CI=2.09~4.65、2.11~5.75)。主刀医师具有151~250例和>250例手术经验是术后并发症发生的保护因素(OR=0.69、0.59;95%CI=0.54~0.88、0.39~0.90)。结论胃癌患者术后并发症发生的相关危险因素有术前合并症、预后营养指数及手术经验。胃癌术前充分评估病情,积极治疗内科疾病,改善营养状态;手术过程中,既要尽量清除病灶,又要减少不必要的损伤,降低术后并发症发生率,促进患者预后。Objective To explore the postoperative complications and the risk factors for gastric cancer.Methods A retrospective analysis of the clinical data of 508 postoperative patients with gastric cancer admitted to Xinhua Hospital Affiliated to Dalian University,Dalian Third People′s Hospital,and Joint Logistics Support Force of PLA No.967 Hospital from January 2010 to May 2020,According to whether postoperative complications occurred,they were divided into complication groups(n=71)and non-complication group(n=437).In the univariate analysis,the factors that were significantly different between the complication group and the uncomplicated group were included in the multivariate logistic regression analysis to analyze whether they were related risk factors.Results Seventy-one of the 508 patients with gastric cancer had postoperative complications,with a postoperative complication rate of 13.98%,with the highest incidence of incision infection and lung infection,with 2.36%and 1.77%,respectively.The results of univariate analysis showed that age of onset,preoperative comorbidities,prognostic nutrition index,surgical scope and surgical experience were the factors related with the occurrence of postoperative complications(P<0.05).The results of the multivariate analysis found that the preoperative comorbidity and prognostic nutrition index were the risk factors for the occurrence of postoperative complications(OR=3.12,3.48;95%CI=2.09-4.65,2.11-5.75).Chief surgeon with 151-250 and>250 surgical experience were protective factors for the occurrence of postoperative complications(OR=0.69,0.59;95%CI=0.54-0.88,0.39-0.90).Conclusion Related risk factors for postoperative complications of gastric cancer patients include preoperative complications,prognostic nutritional index and surgical experience.Fully evaluate the condition before surgery,actively treat medical diseases,and improve nutritional status;during the operation,it is necessary to remove the lesion as much as possible,but also to reduce unnecessary damage,reduce the i

关 键 词：胃癌 术后并发症 术前合并症 预后营养指数 手术经验 

分 类 号：R735.2[医药卫生—肿瘤]