老年胃肠道肿瘤患者术后胃肠功能紊乱情况调查及其影响因素  

Postoperative gastrointestinal dysfunction in elderly patients with gastrointestinal tumor and its influencing factors

作　　者：牛育慧[1] 张亚杰 韩婧[1] Niu Yuhui;Zhang Yajie;Han Jing(Department of General Gastrointestinal Surgery,Heji Hospital Affiliated to Changzhi Medical College,Changzhi 046000,Shanxi Province,China)

机构地区：[1]长治医学院附属和济医院普外胃肠科,山西长治046000

出　　处：《中华老年多器官疾病杂志》2024年第5期346-349,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：山西省应用基础研究计划(201901D111331)。

摘　　要：目的 调查老年胃肠道肿瘤患者术后胃肠功能紊乱情况,并分析其影响因素。方法 回顾性分析长治医学院附属和济医院2020年5月至2023年5月收治的185例胃肠道肿瘤患者的临床资料,依据进食、恶心、呕吐、体检与症状持续时间(I-FEED)评分系统评估患者胃肠功能,将I-FEED评分<6分的患者分为恢复组(n=105),I-FEED评分≥6分的患者分为延迟恢复组(n=80)。采用SPSS 20.0统计软件进行数据分析。按照数据类型,分别选择t检验、方差分析或χ^(2)检验行组间比较。采用多元logistic回归分析患者术后胃肠功能紊乱的影响因素。结果 185例患者I-FEED评分为(4.26±1.04)分,胃肠功能延迟恢复发生率为43.24%(80/185)。多元logistic回归分析结果显示,体质量指数(OR=1.868,95%CI 1.235~2.825)、术前白蛋白(OR=0.643,95%CI 0.455~0.908)、术中出血量(OR=1.680,95%CI 1.044~2.705)及腹腔积液(OR=1.449,95%CI 1.063~1.975)是影响患者术后胃肠功能恢复情况的相关因素(P<0.05)。结论 老年胃肠道肿瘤患者术后较易出现胃肠功能延迟恢复现象,体质量指数高、术前白蛋白低、术中大出血及腹腔积液患者为胃肠功能紊乱高危群体,需要进行针对性干预,以促进患者术后胃肠功能的迅速恢复。Objective To investigate the postoperative gastrointestinal dysfunction in the elderly patients with gastrointestinal tumor and analyze its influencing factors.Methods The clinical data of 185 patients with gastrointestinal tumors admitted to Heji Hospital Affiliated to Changzhi Medical College from May 2020 to May 2023 were retrospectively analyzed.The gastrointestinal function of the patients was evaluated according to intake,feeling nauseated,emesis,physical exam and duration of symptoms(I-FEED)scoring system.The I-FEED score<6 or≥6 points represented the recovery group(n=105)and the delayed recovery group(n=80)respectively.SPSS statistics 20.0 was used for data analysis.According to the data type,the t test,ANOVA,orχ^(2)test was selected for inter-group comparison.Multiple logistic regression was used to analyze the influencing factors of postoperative gastrointestinal dysfunction.Results The I-FEED score of 185 patients was(4.26±1.04)points,and the incidence of delayed gastrointestinal function recovery was 43.24%(80/185).Multiple logistic regression analysis showed that body mass index(OR=1.868,95%CI 1.235-2.825),preoperative albumin(OR=0.643,95%CI 0.455-0.908),intraoperative blood loss(OR=1.680,95%CI 1.044-2.705)and abdominal fluid(OR=1.449,95%CI 1.063-1.975)were the factors affecting postoperative gastrointestinal function recovery(P<0.05).Conclusion The elderly patients with gastrointestinal tumors are more prone to delayed recovery of gastrointestinal function after surgery.Patients with high body mass index,low preoperative albumin,intraoperative massive bleeding and abdominal fluid are high-risk groups for gastrointestinal dysfunction,and targeted intervention is needed to promote rapid recovery of gastrointestinal function after surgery.

关 键 词：老年人 胃肠道肿瘤 手术 胃肠功能紊乱 

分 类 号：R57[医药卫生—消化系统] R735[医药卫生—内科学]