胃癌术后全胃肠外营养治疗中患者出现低血糖的影响因素研究  

Influencing factors of hypoglycaemia in post-operative total parenteral nutrition therapy for gastric cancer

作　　者：严燕燕 吴婉英 付欢英 俞鹏飞 YAN Yan-yan;WU Wan-ying;FU Huan-ying;YU Peng-fei(Department of Abdominal Surgery,the Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Hangzhou,Zhejiang 310012,China)

机构地区：[1]中国科学院大学附属肿瘤医院(浙江省肿瘤医院)腹部外科,浙江杭州310022

出　　处：《中华全科医学》2022年第3期493-497,共5页Chinese Journal of General Practice

基　　金：浙江省自然科学基金项目(LY18H160032)。

摘　　要：目的探讨胃癌术后患者在全胃肠外营养治疗期间出现低血糖的相关因素,为在临床治疗中降低患者低血糖发生率、为医护人员制定有效的预防和干预措施提供理论依据。方法依托临床电子病历系统,采用回顾性研究的方法,收集2018年1月1日—2019年12月31日在中国科学院大学附属肿瘤医院腹部外科行胃癌根治手术的974例患者信息,按照有无发生低血糖,分为低血糖组和非低血糖组,低血糖组为观察组,共126例,非低血糖组为对照组,共848例,采集其临床指标,2组比较年龄、性别、既往史、BMI、手术方式、用药情况和生化指标,单因素分析采用t检验及χ^(2)检验,多因素分析采用二元logistic回归分析。结果本研究共纳入974名患者,男性660例(占比67.8%),女性314例(占比32.2%),年龄为(61.2±10.5)岁,发生低血糖126例(12.9%)。二元logistic回归分析显示:性别、BMI、既往糖尿病史、胰岛素葡萄糖配比与胃癌术后患者全胃肠外营养治疗期间低血糖的发生有关。结论护理中需关注高危人群,有针对性地从改善患者营养状态、安全合理用药、减少术后应激及禁食时间等方面入手,降低低血糖发生率。Objective To explore the related factors of hypoglycaemia in patients with gastric cancer during total parenteral nutrition therapy and to provide a theoretical basis for reducing the incidence of hypoglycaemia in clinical treatment and for medical staff to formulate effective prevention and intervention measures.Methods A retrospective study was used to collect information on 974 patients who underwent radical gastric cancer surgery in the Department of Abdominal Surgery of the Tumor Hospital of the University of Chinese Academy of Sciences from January 1,2018 to December 31,2019.According to whether or not hypoglycaemia occurred,they were divided into hypoglycaemia group and non-hypoglycaemia group.The hypoglycaemia group was the observation group(126 cases),and the non-hypoglycaemia group was the control group(848 cases).The two groups compared their age,gender,past history,BMI,surgical methods,medication status and biochemical indicators.Univariate analysis was performed using t test and χ^(2) test.Multivariate analysis adopted binary logistic regression analysis.Results A total of 974 patients were enrolled in this study,including 660 males(67.8%)and 314 females(32.2%),with an average age of(61.2±10.5)years.A total of 126 cases of hypoglycaemia were reported,with an incidence of 12.9%.Binary logistic regression analysis showed that gender,BMI,previous diabetes history,insulin and glucose ratio were related to the occurrence of hypoglycaemia during total parenteral nutrition therapy in patients after gastric cancer surgery.Conclusion In nursing care,attention should be paid to high-risk groups,and targeted measures should be taken to improve the nutritional status of patients,use drugs safely and rationally,reduce post-operative stress and fasting time and reduce the incidence of hypoglycaemia.

关 键 词：胃癌 胃肠外营养 低血糖 影响因素分析 

分 类 号：R735.2[医药卫生—肿瘤] R459.3[医药卫生—临床医学]