【摘要】：目的分析腹腔鏡輔助胃癌根治術(shù)發(fā)生并發(fā)癥的危險(xiǎn)因素。方法回顧性分析上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院胃腸外科2010年1月至2015年12月收治的245例行腹腔鏡輔助胃癌根治術(shù)病人的臨床資料,通過ROC曲線確定觀察指標(biāo)的臨界值并分組,采用χ~2檢驗(yàn)比較不同分組的并發(fā)癥發(fā)生率,應(yīng)用Logistic回歸法進(jìn)行多因素分析。結(jié)果 245例病人中33例(13.5%)術(shù)后出現(xiàn)并發(fā)癥。在納入分析的17個(gè)觀察指標(biāo)中,BMI≥25(χ~2=12.620,P0.01)、伴發(fā)合并癥1種(χ~2=4.272,P=0.039)、血清白蛋白≤33 g/L(χ~2=6.805,P0.01)、手術(shù)時(shí)間230min(χ~2=7.976,P0.01)、術(shù)中出血量200 m L(χ~2=7.140,P0.01)、圍術(shù)期輸血量600 m L(χ~2=22.686,P0.01)、腫瘤直徑2 cm(χ~2=9.812,P0.01)、術(shù)者操作經(jīng)驗(yàn)欠缺(χ~2=5.896,P=0.015)與腹腔鏡輔助胃癌根治術(shù)并發(fā)癥的發(fā)生率有關(guān)。多因素分析顯示,血清白蛋白(≤33 g/L)、圍手術(shù)期輸血(600 m L)和腫瘤直徑(2 cm)是術(shù)后并發(fā)癥發(fā)生的獨(dú)立影響因素。結(jié)論對(duì)于行腹腔鏡輔助胃癌根治術(shù)病人,術(shù)前審慎評(píng)估全身情況、糾正低蛋白血癥,術(shù)中操作精準(zhǔn)以減少出血和輸血,合理選擇吻合方式,盡早度過學(xué)習(xí)曲線,可有效降低術(shù)后并發(fā)癥的發(fā)生率。
[Abstract]:Objective to analyze the risk factors of complications in laparoscopic assisted radical gastrectomy. Methods the clinical data of 245 patients undergoing laparoscopic assisted radical gastrectomy in Renji Hospital, Shanghai Jiaotong University, from January 2010 to December 2015, were retrospectively analyzed. The critical value of observed indexes was determined by ROC curve and divided into groups. The incidence of complications in different groups was compared by 蠂 ~ 2 test and multivariate analysis was performed by Logistic regression method. Results of 245 patients, 33 (13.5%) had postoperative complications. 鍦ㄧ撼鍏ュ垎鏋愮殑17涓瀵熸寚鏍囦腑,BMI鈮，

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