肝胆外科腹部手术患者术后腹胀影响因素  

Influencing factors and countermeasures of abdominal distension in patients undergoing hepatobiliary surgery

作　　者：阮雅萍 王莉敏[1] 王辉[1] RUAN Yaping;WANG Limin;WANG Hui(Department of Hepatobiliary&Pancreatic and Vascular Surgery,Liyang People’s Hospital,Jiangsu,Liyang 213300,China)

机构地区：[1]江苏省溧阳市人民医院肝胆胰血管外科,213300

出　　处：《河北医药》2022年第20期3148-3150,共3页Hebei Medical Journal

摘　　要：目的探讨分析肝胆外科腹部手术患者术后腹胀影响因素及应对措施。方法选取2018年2月至2020年12月收治的肝细胞癌手术后并发腹胀患者120例,对所有患者腹胀程度进行评估,并进行危险因素的分析。结果120例患者中轻度腹胀患者32例(26.67%),中度腹胀患者44例(36.67%),重度腹胀患者43例(35.83%)。单因素分析结果显示,术中出血量、手术时间、肝门阻断时间以及低血钾等因素为患者术后腹胀发生的危险因素(P<0.05)。Logistics多因素分析不同腹胀程度的危险因素,其中肝门阻断时间、血清低蛋白为中度腹胀危险因素,而肝门阻断时间、血清低钾、手术时间以及血清低蛋白则为重度腹胀危险因素(P<0.05)。结论肝癌细胞患者接受外科手术后,发生腹胀以中重度为主,且受到肝门阻断时间、血清低钾、手术时间以及血清低蛋白等因素的影响,临床因尽早在危险因素基础上进行干预,减少术后腹胀的出现。Objective To explore and analyze the influencing factors and countermeasures of abdominal distension in patients undergoing surgery for hepatocellular carcinoma.Methods In this study,120 abdominal distension patients undergoing surgery for hepatocellular carcinoma were selected in our hospital from February 2018 to December 2020.The degree of abdominal distension of all patients was evaluated and risk factors were analyzed.Results Among the 120 patients,32 had mild abdominal distension for 26.67%,44 patients with moderate abdominal distension for 36.67%,and 43 patients with severe abdominal distension for 35.83%.The univariate analysis showed that intraoperative bleeding volume,operation time,the time of hepatic portal occlusion,and hypokalemia were risk factors for postoperative abdominal distension(P<0.05);Logistics multivariate analysis indicated that the time of hepatic portal occlusion,serum low protein were risk factors for moderate abdominal distension,while the time of hepatic portal occlusion,serum hypokalemia,operation time,and serum low protein were risk factors for severe abdominal distension(P<0.05).Conclusion For patients undergoing surgery for hepatocellular carcinoma,postoperative abdominal distension is mainly moderate to severe,and it is affected by factors such as the time of hepatic portal occlusion,serum hypokalemia,operation time,and serum low protein.Clinical reasons should be carried out on the basis of risk factors as soon as possible intervention to reduce the appearance of postoperative abdominal distension.

关 键 词：肝细胞瘤 术后腹胀 肝门阻断时间 血清低蛋白 Logistics多因素分析 

分 类 号：R656[医药卫生—外科学]