宫颈癌根治术后并发肠梗阻的危险因素分析

Risk Factor of Intestinal Obstruction After Radical Surgery of Cervical Cancer

目的探讨宫颈癌根治术后发生肠梗阻的危险因素。方法回顾性分析2012年6月—2017年6月149例宫颈癌根治术后并发肠梗阻患者的临床资料,与同期行该手术但未发生肠梗阻的2 436例患者资料进行对比,分析并发肠梗阻的危险因素。结果肠梗阻的发生与患者的年龄、手术时间、术后血钾水平、术后禁食时间、术前盆腹腔手术史、BMI、手术入径、术后感染、术后伴发腹腔积液有关(P<0.05)。其中盆腹腔手术史、术后禁食时间长、术后血钾水平低、手术消耗时间长是独立危险因素。而在手术出血量、术后患者血红蛋白水平、术中是否输血方面两组差异无统计学意义(P>0.05)。结论缩短手术时间、鼓励患者术后尽早进食,维持术后血钾水平是预防宫颈癌术后发生肠梗阻的有效措施。

Objective To investigate the risk factors of intestinal obstruction after radical surgery of cervical cancer. Methods We retrospectively analyze the clinical data of 2585 cervical cancer patients underwent radical surgery in Tumor Hospital of Yunnan Province from June 2012 to June 2017. Among them, 149 patients had intestinal obstruction. We comparatively analyzed the risk factors for intestinal obstruction. Results The incidence of intestinal obstruction was related to age, duration of operation, postoperative serum potassium level, postoperative fasting time, the history of preoperative pelvic operation, BMI, operation method, postoperative infection and postoperative peritoneal effusion（P〈0.05）. The history of pelvic operation, long postoperative fasting time, low postoperative blood potassium level and long operation time were independent risk factors. However, there was no statistically significant difference between the two groups in blood loss, hemoglobin level or intraoperative blood transfusion（P〉0.05）. Conclusion Shortening the operation time, encouraging patients to eat early and maintaining the postoperative blood potassium level after operation are the effective measures to prevent the intestinal obstruction after radical surgery of cervical cancer.