胃癌根治术患者术后并发症的危险因素分析  

Risk factors of postoperative complications in patients undergoing radical gas-trectomy for gastric cancer

作　　者：毛仲炫[1] 何容梅 刘敬臣[1] MAO Zhongxuan;HE Rongmei;LIU Jingchen(Anesthesia Surgery Center,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021;Department of Anesthesiology,The Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学第一附属医院麻醉手术中心,广西南宁530021 [2]广西医科大学第二附属医院麻醉科,广西南宁530007

出　　处：《麻醉安全与质控》2024年第4期181-186,共6页Perioperative Safety and Quality Assurance

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A 20220562)。

摘　　要：目的探讨胃癌根治术患者术后并发症的危险因素。方法回顾性分析2016-01/2021-01期间在广西医科大学第一附属医院于手术日首台接受择期胃癌根治术患者327例,根据患者术后是否发生并发症分为并发症组(n=143)和非并发症组(n=184),记录及比较2组患者临床资料,采用多因素Logistic回归分析术后并发症发生的危险因素。结果胃癌根治术患者术后并发症发生率为43.7%(143/327),其中Clavien-Dindo分级为Ⅱ级及以上的术后并发症发生率为35.7%(117/327),死亡率为0.6%(2/327)。术中晶体液总量(P=0.002)是发生术后并发症的独立危险因素,相对于晶体液总量≤1500 mL,术中晶体液总量>2100 mL(OR=2.447,P=0.003)更容易出现术后并发症。术前口服透明碳水化合物饮料(OR=0.5999,P=0.031)可降低术后并发症的风险。结论术中输注晶体液>2100 mL是胃癌根治术患者发生术后并发症的危险因素。Objective To explore the risk factors of postoperative complications in patients undergoing radical gastrectomy for gastric cancer.Methods The data of 327 gastric cancer patients who underwent radical gastrectomy from January 2016 to January 2021 were retrospectively analyzed.According to their postoperative complications,they were divided into two groups,a postoperative complication group(n=143)and a non-postoperative complication group(n=184).The data were recorded and compared between the two groups.The risk factors of postoperative complications were identified by multivariate logistic regression analysis.Results Among the 327 patients,143 patients(43.7%)developed overall postoperative complications,117 patients(35.7%)developed severe postoperative complications(Clavien-Dindo grade≥Ⅱ),2 patients(0.6%)died.The intraoperative crystalloid volume(P=0.002)is an independent risk factor for overall postoperative complications.Compared with crystalloid volume≤1500 mL,intraoperative crystalloid volume>2100 mL(OR=2.447,P=0.003)was more likely to develop overall postoperative complications.Postoperative complications were more likely reduced when patients received preoperative oral carbohydrate treatment(OR=0.5999,P=0.031).Conclusion Intraoperative crystalloid volume>2100 mL is an independent risk factor for overall postoperative complications after radical gastrectomy for gastric cancer.

关 键 词：胃癌根治术 手术后并发症 晶体液 胶体液 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]