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术中隐匿性休克对胃癌D2/D3根治术并发症的影响

Effect of intraoperative cryptic shock on the prognosis of D2/D3 radical resection for gastric carci-noma
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摘要 目的:回顾性分析胃癌D2/D3根治术隐匿性休克的发生率及术后并发症率。方法共选取我院2009年3月至2013年6月胃癌D2/D3根治术老年患者126例,根据动脉血乳酸及收缩压将病例分成三组,即隐匿性休克组、显性休克组、无休克组。隐匿性休克患者占23.8%(30/126),显性休克患者占7.1%(9/126),无休克患者占69.1%(87/126)。比较三组术后并发症的差异性。结果术后7 d并发症,隐匿性休克组为16.7%(95% CI 10~31),显性休克组为22.2%(95% CI 11~36),无休克组为1.1%(95% CI 1~3)。隐匿性休克组和显性休克组术后并发症发生率相当,差异无统计学意义(P =0.953)。结论胃癌D2/D3根治术术中隐匿性休克发生率高,术后并发症发生率与显性休克相当,应引起临床医护人员的重视,及早识别并治疗。 Objective To analyze the incidence of cryptic shock and postoperative complications after D2/D3 radical resection for gastric carcinoma retrospectively.Methods From March 2009 to June 2013,126 elderly patients with D2/D3 radical resection for gastric carcinoma were enrolled.According to the levels of arterial blood lactate and systolic blood pressure,the patients were divided into three groups, including 23.8%(30/126)of cryptic shock,7.1%(9/126)of overt shock and 69.1%(87/126)with no shock.Differences in postoperative complications were compared among groups.Results At the 7th day after operation,the rates of complications were 16.7%(95% CI 10~31)in the cryptic shock group,22. 2%(95% CI 11 ~36)in the overt shock group and 1.1%(95% CI 1~3)in the no shock group.There was no difference in complications between the cryptic shock group and overt shock group(P=0.953). Conclusion During the D2/D3 radical resection for gastric carcinoma,the incidence of cryptic shock is high and it carries a similar complication rate as the overt shock.It should cause the attention of clinical staffs and require early identification and management.
出处 《临床外科杂志》 2014年第6期430-432,共3页 Journal of Clinical Surgery
关键词 隐匿性休克 显性休克 乳酸 胃癌根治术 cryptic shock overt shock lactate radical gastrectomy
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