基于倾向值匹配法分析胃癌患者鼻胃管减压与术后肺部感染发生的相关性  

Association between nasogastric decompression and pulmonary infections in patients after gastrectomy for gastric cancer:an analysis by propensity score matching

作　　者：高俊 王冬梅[1] 谢小艳 杨茗兰 李建[1] Gao Jun;Wang Dongmei;Xie Xiaoyan;Yang Minglan;Li Jian(Mianyang Third People’s Hospital,the Mental Health Centre of Sichuan,Mianyang,621000,China)

机构地区：[1]绵阳市第三人民医院·四川省精神卫生中心,四川绵阳621000

出　　处：《现代临床护理》2023年第9期1-6,共6页Modern Clinical Nursing

基　　金：绵阳市卫生健康委员会科研课题项目,项目编号为202223。

摘　　要：目的分析鼻胃管减压(nasogastric decompression,ND)与胃癌术后肺部感染之间的关联性。方法采取便利抽样法,选择2017年1月至2021年1月本院收治的221例胃癌根治术患者的临床资料。应用倾向值匹配法(propensity score matching,PSM)对有鼻胃管减压组和无鼻胃管减压组进行1:1匹配。以肺部感染发生率为因变量,将鼻胃管减压情况及患者人口学特征、疾病情况共10个协变量为自变量进行Logistic回归分析。结果本研究共纳入221例患者,其中鼻胃管减压127例及无鼻胃管减压94例。匹配后,鼻胃管减压组和无鼻胃管减压组,每组各75例,术后肺部感染总发生率为12.0%(18/150),其中无鼻胃管减压组肺部感染发生率6.7%(5/75)低于鼻胃管减压组肺部感染发生率17.3%(13/75),差异有统计学意义(χ^(2)=4.040,P=0.038)。Logistic回归分析结果显示,鼻胃管减压是胃癌术后肺部感染的独立危险因素,有鼻胃管减压发生肺部感染是无鼻胃管减压的3.160倍(OR=3.160,95%CI 1.220~8.200,P=0.018)。结论鼻胃管减压与胃癌术后肺部感染发生相关,不建议择期手术胃癌患者术后常规留置鼻胃管。Objective To analyse the association between nasogastric decompression(ND)and pulmonary infections in patients after gastrectomy for gastric cancer by the method of propensity score matching.Methods Clinical data of 221 patients who underwent radical gastrectomy for gastric cancer in Mianyang Third People’s Hospital from January 2017 to January 2021 were analysed.Propensity score matching method was used to set up a 1:1 match on ND patient and non-ND patients,where the patients were assigned to a ND group and a non-ND group,respectively.Logistic regression analysis was carried out for the incidence of pulmonary infection as the dependent variable,and ten covariates including nasogastric decompression,patient demography and disease status,etc.as the independent variables.Results Among the 221 patients,127 received ND and the rest 94 did not.According to the propensity score matching,the ND and non-ND groups were set up with 75 patients per group.Total incidence of pulmonary infections was found at 12.0%in the two groups combined(18/150),but the rate of incidence of pulmonary infections in the non-ND group was significantly lower than that in the ND group(6.7%vs.17.3%,χ^(2)=4.040,P=0.038).Logistic regression analysis showed that ND was the independent risk factor of pulmonary infections after gastrectomy:The ND posed 3.16 times pulmonary infections than that of non-ND(OR=3.160,95%CI:1.220-8.200,P=0.018).Conclusions ND is highly associated with the postoperative pulmonary infections in patients after gastrectomy for gastric cancer.This study clearly indicates that a nasogastric decompression should not be considered as a routine treatment of the patients after gastrectomy for gastric cancer.

关 键 词：胃癌 鼻胃管减压 肺部感染 倾向值匹配 

分 类 号：R473.73[医药卫生—护理学]