胃癌术后并发症发生情况及危险因素分析

摘要
图/表
参考文献(21)
相关文章 (15)

全文: PDF (0 KB) HTML (38 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨胃癌术后并发症的发生情况及危险因素。方法回顾性分析2010 年1 月至2020 年5 月大连大学附属新华医院、大连市第三人民医院与解放军联勤保障部队第九六七医院收治的508 例胃癌术后患者的临床资料，根据是否发生术后并发症，将其分为并发症组（n=71）与非并发症组（n=437）。将单因素分析中并发症组与无并发症组存在显著差异的因素纳入多因素logistic 回归分析，分析其是否为相关危险因素。结果 508 例胃癌术后患者中71 例出现术后并发症，术后并发症发生率为13.98%，其中以切口感染及肺部感染发生率最高，分别为2.36%和1.77%。单因素分析结果显示，发病年龄、术前合并症、预后营养指数、手术范围及手术经验是术后并发症发生的相关因素（P＜0.05）。多因素分析结果显示，术前合并症、预后营养指数为术后并发症发生的危险因素（OR=3.12、3.48；95%CI=2.09~4.65、2.11~5.75）。主刀医师具有 151~250 例和>250 例手术经验是术后并发症发生的保护因素（OR=0.69、0.59；95%CI=0.54~0.88、0.39~0.90）。结论胃癌患者术后并发症发生的相关危险因素有术前合并症、预后营养指数及手术经验。胃癌术前充分评估病情，积极治疗内科疾病，改善营养状态；手术过程中，既要尽量清除病灶，又要减少不必要的损伤，降低术后并发症发生率，促进患者预后。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘福全
	常莹
	张狄康
	宋芳华▲

关键词 ：胃癌, 术后并发症, 术前合并症, 预后营养指数, 手术经验

Abstract：Objective To explore the postoperative complications and the risk factors for gastric cancer. Methods A retrospective analysis of the clinical data of 508 postoperative patients with gastric cancer admitted to Xinhua Hospital Affiliated to Dalian University, Dalian Third People′s Hospital, and Joint Logistics Support Force of PLA No.967 Hospital from January 2010 to May 2020, According to whether postoperative complications occurred, they were divided into complication groups (n=71) and non-complication group (n=437). In the univariate analysis, the factors that were significantly different between the complication group and the uncomplicated group were included in the multivariate logistic regression analysis to analyze whether they were related risk factors. Results Seventy-one of the 508 patients with gastric cancer had postoperative complications, with a postoperative complication rate of 13.98%, with the highest incidence of incision infection and lung infection, with 2.36% and 1.77%, respectively. The results of univariate analysis showed that age of onset, preoperative comorbidities, prognostic nutrition index, surgical scope and surgical experience were the factors related with the occurrence of postoperative complications (P<0.05). The results of the multivariate analysis found that the preoperative comorbidity and prognostic nutrition index were the risk factors for the occurrence of postoperative complications (OR=3.12, 3.48; 95%CI=2.09-4.65, 2.11-5.75). Chief surgeon with 151-250 and >250 surgical experience were protective factors for the occurrence of postoperative complications (OR=0.69, 0.59;95%CI=0.54-0.88, 0.39-0.90). Conclusion Related risk factors for postoperative complications of gastric cancer patients include preoperative complications, prognostic nutritional index and surgical experience. Fully evaluate the condition before surgery, actively treat medical diseases, and improve nutritional status; during the operation, it is necessary to remove the lesion as much as possible, but also to reduce unnecessary damage, reduce the incidence of postoperative complications, and promote the prognosis of the patient.

Key words： Gastric cancer Postoperative complications;Preoperative complications Prognostic nutritional index;Surgical experience

基金资助:辽宁省大连市卫生局课题项目（2015-110）

引用本文:

刘福全; 常莹;张狄康; 宋芳华▲. 胃癌术后并发症发生情况及危险因素分析[J]. 中国当代医药, 2021, 28(34): 191-195.
LIU Fu-quan;CHANG Ying;ZHANG Di-kang;SONG Fang-hua▲. Research of postoperative complications and the risk factors for gastric cancer. 中国当代医药, 2021, 28(34): 191-195.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I34/191

[1]	吕恒宇，黄晨，夏翔，等.预测根治性胃癌切除术后并发症危险因素的列线图模型的建立[J].上海交通大学学报（医学版），2020，40（7）：895-900，894.
[2]	陈玲，林晶，陈丽珠，等.胃癌根治术后早期复发转移的影响因素分析[J].肿瘤学杂志，2020，26（12）：1052-1055.
[3]	日本胃癌学会.胃癌治療ガイドライン[M].5 版.东京：金原出版株式会社，2018.
[4]	蓝炘，郗洪庆，张珂诚，等.开放和腹腔镜及机器人胃癌根治术后并发症发生情况的对比分析[J].中华胃肠外科杂志，2017，20（2）：184-189.
[5]	肖华，潘曙光，尹彬，等.胃癌根治术后并发症的Clavien-Dindo 分级及危险因素分析[J].中华医学杂志，2013，93（46）：3667-3670.
[6]	马军兴，刘振军.腹腔镜辅助胃癌根治术对患者术后并发症及应激反应的影响[J].腹腔镜外科杂志，2020，25（8）：567-570.
[8]	郑朝辉，陆俊，黄昌明，等.胃癌根治术后并发症及其相关因素分析[J].中国实用外科杂志，2013，33（4）：317-320.
[10]	朱锦德，吕昕亮，吴春晓，等.225 例老年胃癌临床及术后并发症分析[J].临床外科杂志，2000，8（1）：22-24.
[13]	王玉鹏.胃癌根治性全胃切除术后并发症的影响因素分析[J].中西医结合心血管病电子杂志，2020，8（21）：161.
[7]	Zhuang CL，Huang DD，Pang WY，et al.Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer：Analysis from a Large-Scale Cohort[J].Medicine（Baltimore），2016，95（13）：e3164.
[9]	Zhang WH，Chen XZ，Yang K，et al.Bursectomy and nonbursectomy D2 gastrectomy for advanced gastric cancer，initial experience from a single institution in China[J].World J Surg Oncol，2015，13：332.
[11]	Kobayashi D，Iwata N，Tanaka C，et al.Factors related to occurrence and aggravation of pancreatic fistula after radical gastrectomy for gastric cancer[J].J Surg Oncol，2015，112（4）：381-386.
[12]	Zhuang CL，Wang SL，Huang DD，et al.Risk factors for hospital readmission after radical gastrectomy for gastric cancer：a prospective study[J].PLoS One，2015，10（4）：e0125572.
[14]	李东.老年胃癌术后肺部并发症危险因素分析[J].中华普外科手术学杂志（电子版），2014，8（2）：151-153.
[15]	尹军平，吕桂泉.老年人胃癌术后呼吸系统并发症临床危险因素分析[J].肿瘤学杂志，2011，17（4）：260-262.
[16]	Zhang WH，Chen XZ，Yang K，et al.Risk Factors and Survival Outcomes for Postoperative Pulmonary Complications in Gastric Cancer Patients[J].Hepatogastroenterology，2015，62（139）：766-772.
[17]	黄昌明，林建贤，郑朝辉，等.腹腔镜辅助胃癌根治术后并发症及其相关因素分析[J].中华胃肠外科杂志，2011，14（5）：347-351.
[18]	Hamakawa T，Kurokawa Y，Mikami J，et al.Risk factors for postoperative complications after gastrectomy in gastric cancer patients with comorbidities[J].Surg Today，2016，46（2）：224-228.
[19]	胡建昆，赵林勇.腹腔镜胃癌根治联合脏器切除的现状与发展[J].中华普外科手术学杂志（电子版），2017，11（6）：457-460.
[20]	Kang SC，Kim HI，Kim MG.Low Serum Albumin Level，Male Sex， and Total Gastrectomy Are Risk Factors of Severe Postoperative Complications in Elderly Gastric Cancer Patients[J].J Gastric Cancer，2016，16（1）：43-50.
[21]	Li Y，Tan B，Fan L，et al.Clinicopathologic Characteristics of Elderly with Gastric Cancer，and the Risk Factors of Postoperative Complications[J].J Invest Surg，2017，3：1-7.