Ⅰa～Ⅱa期宫颈癌患者腹腔镜根治术后并发肠梗阻的危险因素分析

Risk factors for intestinal obstruction after laparoscopic radical resection for patients with cervical cancer in stage Ⅰa～Ⅱa

目的探讨Ⅰa~Ⅱa期宫颈癌患者腹腔镜根治术后并发肠梗阻的危险因素。方法回顾性分析2014年5月至2018年5月本院收治的行腹腔镜根治术治疗的718例Ⅰa~Ⅱa期宫颈癌患者的临床资料,分析患者术后肠梗阻发生情况,并采用Logistic逐步回归模型分析影响患者术后并发肠梗阻的独立危险因素。结果718例行腹腔镜根治术治疗的Ⅰa~Ⅱa期宫颈癌患者中,68例(9.47%)发生术后肠梗阻。多因素Logistic回归分析显示,年龄≥50岁、手术时间≥120min、有胃肠功能紊乱史、全身麻醉、术中操作损伤及术后3d血清白蛋白水平≤30g/L均为Ⅰa~Ⅱa期宫颈癌患者腹腔镜根治术后发生肠梗阻的独立危险因素(均P<0.05)。结论Ⅰa~Ⅱa期宫颈癌患者腹腔镜根治术后并发肠梗阻受多种因素影响,临床上应评估患者存在的危险因素并采取有效的治疗措施,以降低肠梗阻发生率,提高患者生活质量。

Objective To investigate the risk factors of intestinal obstruction after laparoscopic radical resection for patients with cervical cancer in stage Ⅰa ~Ⅱa.Method The clinical data of 718 patients with cervical cancer in stage Ⅰa ~Ⅱa treated by laparoscopic radical operation in our hospital from May 2014 to May 2018 were retrospectively analyzed.The occurrence of intestinal obstruction after operation was analyzed.Logistic stepwise regression model was used to analyze the independent risk factors affecting intestinal obstruction after operation.Result Of 718 patients with cervical cancer in stage Ⅰa ~Ⅱa underwent laparoscopic radical surgery,68 cases (9.47%) had postoperative intestinal obstruction.Multivariate Logistic regression analysis showed that age ≥ 50 years old,operation time ≥ 120 minutes,had the history of gastrointestinal dysfunction,general anesthesia,intraoperative injury during operation and serum albumin level ≤ 30 g/L 3 days after operation were the independent risk factors for intestinal obstruction after laparoscopic radical operation in patients with cervical cancer in stage Ⅰa ~Ⅱa (all P < 0.05).Conclusion Intestinal obstruction after laparoscopic radical operation for ptients with cervical cancer in Ⅰa ~Ⅱa is affected by many factors.Clinical risk factors should be evaluated and effective treatment measures should be taken to reduce the incidence of intestinal obstruction,improve the quality of life of patients.