摘要
目的探讨分析腹腔镜下胃癌根治术后并发症发生的危险因素分析。方法选取2014年1月～2015年12月在我院进行胃癌根治性手术治疗的原发性胃癌患者423例作为研究对象；对所有受试者的临床资料进行统计分析。结果本研究共98例发生并发症，并发症发生率为23．2％（98／423），包括切口并发症4例（4．1％），乳糜漏8例（8．2％），肠梗阻7例（7．1％），吻合口出血8例（8．2％），胰瘘4例（4．1％），吻合口瘘3例（3．1％），十二指肠残端瘘2例（2．0％），胃十二指肠动脉出血2例（2．0％），败血症3例（3．1％），肝功能损害7例（7．1％），肺部感染26例（26．5％），腹腔感染16例（16．3％），泌尿系统感染8例（8．2％）。单因素分析结果显示：术前是否有合并症、肿瘤直径、浸润深度、淋巴结转移、手术时间及术前营养状况均与腹腔镜下胃癌根治术后并发症发生相关；多因素Logistic回归分析结果显示：术前有合并症、肿瘤直径≥5cm、有淋巴结转移、手术时间长及术前营养差均为腹腔镜下胃癌根治术后并发症发生的危险因素。结论腹腔镜下胃癌根治术后并发症的发生受多种因素的影响，在应结合已发现的腹腔镜下胃癌根治术后并发症发生的高危因素进行积极预防，以期降低腹腔镜下胃癌根治术后并发症的发生率。
Objective To explore the risk factors of complications after laparoscopy-assisted radical gastrectomy. Methods From Jan. 2014 to Dec. 2015, 423 cases of patients with radical gastrectomy from our hospital Were selected and all the clinical data were analyzed. Results There were 98 complications and the incidence rate of complication was 23.2%（98/423）. There were 4 cases（4.1%） of incision complication, 8 eases（8.2%） of chylous leakage, 7 cases（7.1%） of ileus, 8 cases （8.2%） of anastomotie bleeding, 4 cases（4.1%） of pancreatic fistula, 3 cases（3.1%） of anastomotic fistula, 2 cases（2.0%） of duodenum stump fistula, 2 cases （2.0%） of Gastroduodenal artery bleeding, 3 cases（3.1%） of sepsis, 7 cases（7,1%） of hepatic function damage, 26 cases（26.5%） of pneumonia, 16 cases（16.3%） of intra-abdominal infection and 8 case（8.2%） of urinary system infection. Single factor analysis showed that postoperative complications, diameter of tumor, depth of invasion, lympho node metastasis, operative time and preoperative nutritional status were related with complications after laparoscopy-assisted radical gastrectomy. Logistic regression model shows that the risk factors of complications after laparoscopy-assisted radical gastrectomy were postoperative complications, tumor ≥5cm, lymph node metastasis, longer operative time and poor nutritional condition. Conclusion There are more risk factors related with complications after laparoscopy-assisted radical gastrectomy. So for the cases which come out with above risk factors should pay more attention to reduce complications after laparoscopy-assisted radical gastrectomy.
出处
《中国医药科学》
2016年第18期191-193,共3页
China Medicine And Pharmacy
关键词
胃癌
根治手术
腹腔镜
术后并发症
LOGISTIC分析
Gastric carcinoma
Radical operation
Laparoscopy
Complications
Logistic regression model
