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作 者:叶婧 吴丹 罗德胜 姜川 YE Jing;WU Dan;LUO Desheng;JIANG Chuan(Cadres Health Care Office,Lishui Central Hospital,Zhejiang Province,Lishui 323000,China;Department of Gastroenterology,Abdominal Wall and Hernia,Lishui Central Hospital,Zhejiang Province,Lishui 323000,China)
机构地区:[1]浙江省丽水市中心医院干部保健办,浙江丽水323000 [2]浙江省丽水市中心医院胃肠外科、疝腹与壁外科,浙江丽水323000
出 处:《中国医药导报》2024年第15期49-51,70,共4页China Medical Herald
摘 要:目的 分析胃癌患者术后肠内营养(EN)期间引起腹泻的危险因素及干预对策。方法 回顾性收集2019年6月至2023年6月浙江省丽水市中心医院就诊的216例行胃癌根治术并于术后行EN患者的临床资料。根据腹泻发生情况将其分为腹泻组和未腹泻组,采用单因素和多因素logistic回归分析胃癌患者术后EN期间腹泻发生的影响因素。结果 216例胃癌患者中术后EN期间有141例患者出现腹泻,其发生率为65.28%。两组年龄、手术方式、EN开始时间、营养途径、使用营养泵、术后第1天下床活动时间比较,差异有统计学意义(P<0.05)。年龄≥60岁(OR=3.808,95%CI:2.034~7.129),开腹(OR=4.811,95%CI:1.456~15.904),EN开始时间为术后24 h(OR=5.033,95%CI:1.637~15.473)、未使用营养泵(OR=4.874,95%CI:3.099~7.666)、术后第1天下床活动时间<1 h(OR=2.612,95%CI:1.153~5.914)是胃癌患者术后EN期间腹泻发生的独立危险因素(P<0.05)。结论 胃癌患者术后EN期间腹泻的发生是多种因素影响的结果,临床针对性进行干预有助于预防腹泻的发生。Objective To analyze the risk factors and intervention strategies of postoperative enteral nutrition(EN) induced diarrhea in patients with gastric cancer.Methods Clinical data of 216 patients who underwent radical gastrectomy and underwent EN after surgery in Lishui Central Hospital,Zhejiang Province from June 2019 to June 2023 were retrospectively collected.The patients were divided into diarrhea group and no diarrhea group according to the occurrence of diarrhea.Univariate and multivariate logistic regression were used to analyze the risk factors affecting the occurrence of diarrhea in gastric cancer patients during EN after surgery.Results Among 216 patients with gastric cancer,diarrhea occurred in 141patients during EN after surgery,with an incidence of 65.28%.There were statistically significant differences between the two groups in age,operation method,EN start time,nutrition pathway,use of nutrition pump,and the first day of bed activity after surgery(P<0.05).Age ≥60 years(OR=3.808,95%CI:2.034-7.129),laparotomy(OR=4.811,95%CI:1.456-15.904),EN onset time was 24 h after surgery(OR=5.033,95%CI:1.637-15.473),no nutritional pump was used(OR=4.874,95%CI:3.099-7.666),and the time of bed movement on the first day after surgery was<1 h(OR=2.612,95%CI:1.153-5.914) were independent risk factors for postoperative diarrhea in patients with gastric cancer(P<0.05).Conclusion The occurrence of diarrhea in gastric cancer patients during EN after operation is the result of many factors,and targeted clinical intervention is helpful to prevent the occurrence of diarrhea.
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