腹腔镜下胰十二指肠切除术后胃排空延迟的影响因素分析  

Analysis of influencing factors on delayed gastric emptying after laparoscopic pancreaticoduodenectomy

作　　者：唐志良[1] 谢源 聂冰[1] TANG Zhiliang;XIE Yuan;NIE Bing(Department of Hepatobiliary Pancreatic Hernia Surgery,First People's Hospital of Zhaoqing City,Zhaoqing,Guangdong 526000 China)

机构地区：[1]肇庆市第一人民医院肝胆胰疝外科,广东肇庆526000

出　　处：《大医生》2024年第23期1-4,共4页Doctor

摘　　要：目的探讨腹腔镜下胰十二指肠切除(LPD)术后胃排空延迟(DGE)的影响因素,为临床治疗提供参考。方法选取2019年1月至2024年5月肇庆市第一人民医院收治的515例行LPD术患者的临床资料,进行回顾性分析。根据术后是否出现DGE分为非DGE组(345例)和DGE组(170例)。比较两组患者的临床资料,分析影响LPD术后DGE的独立危险因素。结果两组患者年龄、合并高血压、性别、BMI、手术用时、总胆红素水平、血红蛋白水平比较,差异均无统计学意义(均P>0.05)。DGE组患者合并糖尿病、合并腹腔感染、合并低白蛋白血症、术前胆道引流、术中输血、术后胰瘘、营养不良占比均高于非DGE组,谷丙转氨酶水平高于非DGE组,术后下床用时长于非DGE组(均P<0.05)。多因素Logistic回归分析结果显示:合并糖尿病、合并腹腔感染、合并低白蛋白血症、术中输血、术后胰瘘、营养不良均为影响LPD术后DGE的独立危险因素(均P<0.05)。结论合并糖尿病、合并腹腔感染、合并低白蛋白血症、术中输血、术后胰瘘、营养不良均为影响LPD术后DGE的独立危险因素,临床可根据上述因素实施相应的干预措施,以预防DGE的发生。Objective to investigate the influencing factors of gastric emptying delay(DGE)after laparoscopic pancreaticoduodenectomy(LPD),and to provide reference for clinical treatment.Methods A retrospective analysis was performed on the clinical data of 515 patients who underwent LPD in the First People's Hospital of Zhaoqing from January 2019 to May 2024.According to whether DGE occurred after surgery,they were divided into non-DGE group(345 cases)and DGE group(170 cases).The clinical data of the two groups were compared,and the independent risk factors affecting DGE after LPD surgery were analyzed.Results There were no significant differences in age、hypertension、gender、BMI、operation time、total bilirubin level and hemoglobin level between the two groups(all P>0.05).The proportions of patients in the DGE group with diabetes mellitus、intra-abdominal infection、hypoalbuminemia、preoperative biliary drainage、intraoperative blood transfusion、postoperative pancreaticfistula and malnutrition were higher than those in the non-DGE group,and the level of alanine aminotransferase was higher than that in the non-DGE group,and the time taken to get out of bed after surgery was higher than that in the non-DGE group(allP>0.05).Multivariate Logistic regression analysis showed that diabetes mellitus、intra-abdominal infection、hypoalbuminemia、intraoperative blood transfusion、postoperative pancreaticfistula and malnutrition were independent risk factors for postoperative DGE of LPD(all P>0.05).Conclusion Diabetes mellitus、intraceliac infection、hypoalbuminemia、intraoperative blood transfusion、postoperative pancreaticfistula and malnutrition are all independent risk factors affecting DGE after LPD,and corresponding interventions can be implemented according to the above factors to prevent the occurrence of DGE.

关 键 词：腹腔镜 胰十二指肠切除术 胃排空延迟 影响因素 

分 类 号：R574.51[医药卫生—消化系统]