腹腔镜胃癌切除术后胃排空障碍相关危险因素分析  

Analysis of risk factors related to delayed gastric emptying after laparoscopic gastrectomy

作　　者：胡水清 王宏波 鲁爱侠 张军[1] 丁光辉 刘盈洲 戴庆涛 赵连军 邓国金 于睿智 HU Shuiqing;WANG Hongbo;LU Aixia;ZHANG Jun;DING Guanghui;LIU Yingzhou;DAI Qingtao;ZHAO Lianjun;DENG Guojin;YU Ruizhi(Department of Gastrointestinal Surgery,Qingdao Jimo People′s Hospital Affiliated to Binzhou Medical University,Qingdao,Shandong 266200,China)

机构地区：[1]滨州医学院附属青岛即墨人民医院胃肠外科,山东青岛266200

出　　处：《现代医药卫生》2023年第13期2206-2210,共5页Journal of Modern Medicine & Health

基　　金：山东省青岛市医药卫生科研计划项目(2021-WJZD304)。

摘　　要：目的 探讨腹腔镜胃癌切除术后胃排空障碍(DGE)的相关危险因素。方法 收集整理2018年1月至2022年6月该院收治的胃癌腹腔镜切除术患者330例,根据DGE发生情况将研究对象分为DGE组(25例)和非DGE组(305例)。比较2组手术时间、术中出血量、术后病理TNM分期、肿瘤直径、消化道重建方式、Clavein分级、腹腔热灌注化疗(HIPEC)情况,分析术后DGE危险因素。结果 2组在年龄分层、陈旧性心肌梗死、≥2种内科并发症、住院时间、住院费用方面比较,差异有统计学意义(P<0.05)。2组在手术时间、术中出血量、TNM分期、肿瘤直径、Clavein分级方面比较,差异无统计学意义(P>0.05)。2组在消化道重建方式、HIPEC方面比较,差异有统计学意义(P<0.05)。≥2种内科并发症、HIPEC是术后DGE的独立危险因素(P<0.05)。结论 腹腔镜胃癌切除术患者术后发生DGE会延长住院时间、增加住院费用,且≥2种内科并发症、HIPEC是术后DGE的独立危险因素。Objective To explore the relevant risk factors of delayed gastric emptying(DGE)after laparoscopic gastrectomy for gastric cancer.Methods A total of 330 patients with gastric cancer undergoing laparoscopic gastrectomy admitted to this hospital from January 2018 to June 2022 were collected.Based on the incidence of DGE,the study subjects were divided into the DGE group(25 cases)and the non-DGE group(305 cases).The operation time,intraoperative bleeding loss,postoperative pathological TNM stage,tumor diameter,digestive tract reconstruction mode,Clavein grade,hyperthermic intraperitoneal chemotherapy(HIPEC)were compared between two groups,and the risk factors for postoperative DGE were analyzed.Results There were statistically significant differences in age stratification,old myocardial infarction,≥2 types of internal medicine comorbidities,hospital stay and hospitalization cost between the two groups(P<0.05).There were no statistically significant differences in operation time,intraoperative blood loss,TNM stage,tumor diameter,and Clavein grade between the two groups(P>0.05).There were statistically significant differences in digestive tract reconstruction method and HIPEC between the two groups(P<0.05).≥2 types of internal medicine comorbidities and HIPEC were independent risk factors for postoperative DGE(P<0.05).Conclusion Postoperative DGE in patients undergoing laparoscopic gastrectomy can prolong hospital stay and increase hospitalization cost,and≥2 types of internal medicine comorbidities and HIPEC are independent risk factors for postoperative DGE.

关 键 词：胃癌 腹腔镜 胃排空障碍 危险因素 

分 类 号：R656.6[医药卫生—外科学]