胃癌根治术后胃排空延迟的危险因素分析及其对预后的影响

Risk factors of delayed gastric emptying and its influence on the prognosis after radical gastrectomy for distal gastric cancer

目的分析胃癌根治术后发生胃排空延迟(DGE)的危险因素及其对预后的影响。方法回顾性分析2007年7月至2018年1月福建省肿瘤医院收治的1447例行胃癌根治术患者的临床病理资料,分析DGE的危险因素及其与预后的关系。结果1447例行胃癌根治术患者中101例(7.0%)患者术后发生DGE,术后平均第(6.0±2.1)天发生DGE。年龄、糖尿病、术前血清白蛋白、术前幽门梗阻、手术时间、手术方式、手术吻合方式、术后镇痛方式与DGE的发生均有关(均P<0.05)。多因素分析显示,术前血清白蛋白、糖尿病、术前幽门梗阻、手术方式、术后镇痛方式及手术吻合方式是发生DGE的独立危险因素。DGE患者术后平均住院时间长于无DGE患者[(16.3±4.2)d比(8.1±2.1)d,P<0.05]。DGE患者和无DGE患者的术后5年生存率分别为54.9%和54.2%,差异无统计学意义(P>0.05)。结论DGE延长胃癌患者的术后住院时间,但不影响其预后。术前血清白蛋白、糖尿病、术前幽门梗阻、手术方式、术后镇痛方式及手术吻合方式均是发生DGE的危险因素。

Objective To analyze the risk factor of delayed gastric emptying(DGE)and the impact of DGE on prognosis after radical gastrectomy of distal gastric carcinoma.Methods The clinical and pathological data of 1447 distant gastric cancer patients undergoing gastrectomy from Jul 2007 to Jan 2018 at Fujian Tumour Hospital was analyzed retrospectively.Result DGE was found in 101 patients(7.0%),occurring at a median of(6.0±2.1)d after surgery.It was significantly correled with age,diabetes,hypoproteinemia,preoperative pyloric obstruction,operation time,surgical mode,anastomotic procedure,postoperative analgesia(all P<0.05).Multivariate analysis showed that hypoproteinemia,diabetes,pyloric obstruction in preoperative period,surgical mode,postoperative analgesia,anastomotic procedure were independently associated with DGE.The average hospitalization time for DGE was significantly longer than patients with non DGE(16.3±4.2)d vs(8.1±2.1)d,P<0.05.The five-year survival of patients with DGE and non DGE were 54.9%and 54.2%respectively(P>0.05)Conclusion DGE prolonged hospital stay,but did not influence patients′prognosis.