518例根治性全胃切除术后并发症危险因素多因素分析

Multivariate analysis of risk factors for postoperative complications of radical total gastrectomy on gastric cancer

目的 探讨根治性全胃切除术后并发症的主要危险因素.方法 回顾性分析该院2005年1月～2010年5月期间行根治性全胃切除术患者的临床资料,对其术前状态、手术因素、肿瘤因素等指标进行单因素分析,并对其中有统计学意义的变量做多因素Logistic回归分析,找出影响术后并发症的危险因素.结果 影响术后并发症的主要危险因素是联合脏器切除、经胸腹联合手术、术前合并症、术中失血量,而白蛋白水平、术中输血是其保护因素.结论 联合脏器切除、经胸腹联合手术、术前合并症、术中失血量是根治性全胃切除术后并发症的独立危险因素,白蛋白水平和术中输血是其保护因素,而淋巴结清扫范围并不是影响术后并发症的主要因素.

Aim To investigate the main risk factors of postoperative complications of radical toal gastrectomy for gastric cancer.Methods The clinical data of 518 patients undergoing radical total gastrectomy between January 2005 and May 2010 were analyzed retrospectively.Firstly,single factors analysis was used in the factors of preoperative status,operation factors,tumor factors,et al.Then,multivariate logistic regression analysis was used in the selected variables,and the risk factors of postoperative complications were found.Results Postoperative complications were associated with combined organ resection,abdominothoracic gastrectomy,preoperative complications and blood loss.But albumin levels and blood transfusion were protective factors.Conclusions Combined organ resection,transabdomen combined thoracic operation,preoperative complications and blood loss are the independent risk factors associated with radical total gastrectomy,and albumin levels and blood transfusion are its protective factors.But,extent of lymph node dissection is not main risk factor of the postoperative complications.