腹腔镜直肠癌前切除术后患者胃肠功能恢复的影响因素分析  

Analysis of Factors Influencing Gastrointestinal Function Recovery after Laparoscopic Anterior Resection of Rectal Cancer

作　　者：杨战锋[1] 陈天然 吴万庆[1] 罗昭锋 郭晓磊[1] YANG Zhanfeng;CHEN Tianran;WU Wanqing(Department of Gastrointestinal Surgery,The Fifth Affiliated Hospital of Zhengzhou University,Henan 450000,China)

机构地区：[1]郑州大学第五附属医院,450000

出　　处：《医学研究杂志》2022年第4期104-108,共5页Journal of Medical Research

摘　　要：目的探讨腹腔镜直肠癌前切除术后影响胃肠功能恢复的相关因素。方法回顾性分析2018年1月~2021年1月80例在笔者医院科室行腹腔镜直肠癌前切除术患者的临床资料,采用I-FEED评分系统评估患者术后胃肠道功能,根据I-FEED评分将患者分为胃肠功能顺利恢复组(I-FEED评分<6分,52例)和胃肠功能延迟恢复组(I-FEED评分≥6分,28例),通过单因素分析及多因素Logistic回归分析影响患者术后胃肠道功能恢复的相关因素。结果单因素分析显示,患者年龄、性别、术前有无糖尿病、术前血红蛋白、手术时间、术中出血量、病理分期等比较,差异均无统计学意义(P>0.05),体重指数(BMI)(P=0.025)、术前白蛋白(P=0.002)、肠系膜下动脉结扎位置(P=0.005)、肿瘤位置(P=0.038)是术后胃肠道功能恢复的相关影响因素,多因素Logistic回归分析显示术前低白蛋白(OR=4.245,95%CI为1.398~12.888,P=0.011)、肠系膜下动脉高位结扎(OR=4.403,95%CI为1.385~13.995,P=0.012)、中低位直肠癌(OR=3.953,95%CI为1.263~12.373,P=0.018)是术后胃肠功能延迟恢复的独立危险因素。结论术前白蛋白、肠系膜下动脉结扎位置、肿瘤位置是影响腹腔镜下直肠癌前切除术后胃肠道功能恢复的相关因素。Objective To explore the factors influencing gastrointestinal function recovery after laparoscopic anterior resection of rectal cancer.Methods From January 2018 to January 2021,clinical data of 80 patients undergoing laparoscopic anterior resection of rectal cancer were retrospectively analyzed.I-FEED scoring system was using to evaluate the gastrointestinal function of patients.Normal recovery group(I-FEED score<6,n=52)and delayed recovery group(I-FEED score≥6,n=28)were divided according to I-FEED scoring system.Univariate analysis and multivariate Logistic regression analysis were performed to identified the related factors influencing gastrointestinal function recovery.Results Univariate analysis showed that no significant differences existed in age,sex,preoperative diabetes,preoperative hemoglobin,time of operation,bleeding during operation,pathological stage.However,body mass index(P=0.025),preoperative albumin(P=0.002),ligation site of the inferior mesenteric artery(P=0.005)and tumor location(P=0.038)were correlated with the recovery of postoperative gastrointestinal function.Multivariate Logistic regression analysis showed that low preoperative albumin(OR=4.245,95%CI:1.398-12.888,P=0.011),high ligation of the inferior mesenteric artery(OR=4.403,95%CI:1.385-13.995,P=0.012)and middle and low rectal carcinoma(OR=3.953,95%CI:1.263-12.373,P=0.018)were independent influencing factors of postoperative gastrointestinal function delayed recovery.Conclusion Preoperative albumin,ligation site of the inferior mesenteric artery and tumor location are related factors influencing gastrointestinal function recovery after laparoscopic anterior resection of rectal cancer.

关 键 词：腹腔镜 直肠癌 前切除术 胃肠功能恢复 影响因素 

分 类 号：R61[医药卫生—外科学]