【摘要】：目的:回顧性研究根治性遠(yuǎn)端胃大部切除術(shù)后胃癱綜合征及術(shù)后正常對(duì)照組的患者病歷資料,找出可能誘發(fā)PGS的危險(xiǎn)因素,以期降低胃癌根治術(shù)后殘胃胃癱的發(fā)生率。方法:查閱2007年1月到2016年12月收治山西省人民醫(yī)院普通外科的根治性遠(yuǎn)端胃大部切除術(shù)患者的病歷資料,對(duì)符合標(biāo)準(zhǔn)的335例病例進(jìn)行相關(guān)數(shù)據(jù)資料統(tǒng)計(jì)。根據(jù)是否發(fā)生PGS分病例組和對(duì)照組,應(yīng)用統(tǒng)計(jì)軟件分析兩組患者在一般資料、術(shù)前、手術(shù)及術(shù)后因素等方面的差異,找出可能與PGS有關(guān)的因素;對(duì)差異有統(tǒng)計(jì)學(xué)意義的因素再進(jìn)行Logistic多因素回歸分析。結(jié)果:335例入選病例中有23例發(fā)生PGS,發(fā)病率6.87%。單因素分析結(jié)果提示低體重指數(shù)(≤18.5kg/m2)、術(shù)前低白蛋白血癥(30g/L)、圍手術(shù)期高血糖(8.0mmol/L)、術(shù)前幽門梗阻、吻合方式(Billroth II或胃空腸Roux-en-Y式)及術(shù)后腹腔并發(fā)癥與根治性遠(yuǎn)端胃大部切除術(shù)后胃癱相關(guān),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。Logistic多因素回歸分析發(fā)現(xiàn)術(shù)前低白蛋白血癥(P=0.012)、圍手術(shù)期高血糖(P=0.009)、術(shù)前幽門梗阻(P=0.030)、吻合方式(Billroth II或胃空腸Roux-en-Y式)(P=0.045)及術(shù)后腹腔并發(fā)癥(P=0.036)是PGS的獨(dú)立危險(xiǎn)因素。結(jié)論:PGS與多因素相關(guān),術(shù)前糾正低蛋白血癥、圍手術(shù)期控制血糖、術(shù)前幽門梗阻患者充分胃腸減壓、洗胃、Billroth I式吻合以及預(yù)防腹腔并發(fā)癥,可能降低并減少PGS的發(fā)生。
[Abstract]:Objective: to study retrospectively the medical records of patients with gastroparesis syndrome after radical distal gastrectomy and postoperative normal control group, and to find out the risk factors of inducing PGS in order to reduce the incidence of residual gastroparesis after radical gastrectomy. Methods: the medical records of 335 patients with radical distal subtotal gastrectomy admitted to Shanxi Provincial people's Hospital from January 2007 to December 2016 were reviewed. According to whether the occurrence of PGS was divided into case group and control group, statistical software was used to analyze the differences in general data, preoperative, operative and postoperative factors between the two groups, and to find out the possible factors related to PGS. Logistic multivariate regression analysis was performed on the statistically significant factors. Results: the incidence of PGS, was 6.87 in 23 out of 335 selected cases. Univariate analysis showed that low body mass index (鈮，

本文編號(hào)：2421096