延迟性术后肠梗阻的围手术期影响因素分析  

Analysis of perioperative influencing factors in delayed postoperative intestinal paralysis

作　　者：柴雅晖 张雅兰 刘帆[1] 宋爱琳[1,2] Chai Yahui;Zhang Yalan;Liu Fan;Song Ailin(The Second Clinical Medical School,Lanzhou University,Lanzhou 730030,China;Partment of General Surgery,The Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730030 [2]兰州大学第二医院普通外科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2023年第3期52-56,62,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省自然科学基金资助项目(20JR5RA342)。

摘　　要：目的 探讨腹部手术患者发生延迟性术后肠梗阻的影响因素。方法 采用巢式病例对照研究的方法,选取2022年9月-12月期间于兰州大学第二医院普通外科就诊并行腹部手术治疗的92例患者为研究对象,并以是否发生延迟性术后肠梗阻为结局,将患者分为病例组和对照组,探讨延迟性术后肠梗阻的风险因素。结果 92例行腹部手术的患者中有30例(32.61%)发生延迟性术后肠梗阻。单因素分析显示,住院时间、手术时间、手术部位、手术方式、术中总入量、术后是否使用镇痛泵及术后第1天的白细胞计数、中性粒细胞计数、球蛋白浓度与延迟性术后肠梗阻的发生相关(P<0.05)。多因素分析结果显示,术后使用镇痛泵(OR=18.676,P=0.025)是延迟性术后肠梗阻发生的独立危险因素。结论 术后使用镇痛泵是腹部手术后患者出现延迟性术后肠梗阻的主要危险因素。Objective To investigate the influencing factors of prolonged postoperative ileus in patients undergoing abdominal surgery.Methods A nested case-control study was used to enlist 92 patients who attended the Department of General Surgery and abdominal surgery at the Second Hospital of Lanzhou University from September 2022 to December 2022 to report the occurrence of prolonged postoperative ileus.Patients with prolonged postoperative ileus were classified into the case group,and other patients without prolonged postoperative ileus were classified into the control group to explore the risk factors of prolonged postoperative ileus.Results Prolonged postoperative ileus occurred in 30(32.61%)of the 92 patients undergoing abdominal surgery.Univariate analysis showed that hospital day,time to surgery,site of surgery,surgical options,total intraoperative intake,use of analgesic pumps,and white blood cell count,neutrophil count,and globulin concentration on the first postoperative day were significantly associated with the occurrence of prolonged postoperative ileus(P<0.05).The results of multivariate analysis showed that use of postoperative analgesia pump(OR=18.676,P=0.025)was an independent risk factor for the occurrence of prolonged postoperative ileus.Conclusion The use of postoperative analgesia pump is a major risk factor for prolonged postoperative ileus in patients after abdominal surgery.

关 键 词：延迟性术后肠梗阻 围手术期 危险因素 

分 类 号：R619.9[医药卫生—外科学]