伴发疾病对胃癌微创手术患者腹部并发症发病影响的研究

Study on the effect of comorbidities on abdominal complications in prtients with minimally invasive surgery of gastric cancer

[目的]探讨伴发疾病对胃癌微创手术患者腹部并发症发病的影响。[方法]回顾性分析2015年1月至2019年6月间于信阳市肛肠医院和信阳市中心医院接受微创手术治疗的612例胃癌患者的临床资料,其中102例患者发生术后腹部并发症,59例患者存在术前伴发疾病。分析胃癌微创手术患者腹部并发症的危险因素,比较不同术前伴发疾病种类患者微创手术后腹部并发症发生情况。[结果]单因素分析结果显示,年龄、BMI、术前伴发疾病数目、手术时间、术中出血量是影响微创手术胃癌患者术后发生腹部并发症的相关因素(P<0.05)。多因素分析结果显示,BMI、术前伴发疾病数目、术中出血量是影响微创手术胃癌患者术后发生腹部并发症的独立因素(P<0.05)。术前伴发高血压或贫血患者术后出血的发生率明显高于其他疾病,术前伴发糖尿病患者术后感染的发生率明显高于其他疾病,差异具有统计学意义(P<0.05)。[结论]术前伴发疾病是影响胃癌微创手术患者术后发生腹部并发症的独立因素。

[Objective]To discuss the effect of comorbidities on abdominal complications after minimally invasive surgery for patients with gastric cancer.[Methods]The clinical data of 612 patients with gastric cancer who underwent minimally invasive surgery from Jan 2015 to Jun 2019 in Xinyang anorectal hospital and Xinyang central hospital were retrospectively analyzed.There were 102 patients with postoperative abdominal complications,including 59 with preoperative comorbidities.The risk factors of abdominal complications after minimally invasive surgery were analyzed,and the incidence of abdominal complications among the patients with different kinds of comorbidities were compared.[Results]The results of univariate analysis showed that age,BMI,number of preoperative comorbidities,operation time and intraoperative blood loss were related factors affecting abdominal complications of patients after minimally invasive surgery(P<0.05).Results of multivariate analysis showed that BMI,number of preoperative comorbidities and intraoperative blood loss were independent factors affecting abdominal complications of patients after minimally invasive surgery(P<0.05).The incidence of postoperative bleeding in patients with hypertension or anemia was significantly higher than that of other diseases(P<0.05).The incidence of postoperative infection in patients with diabetes was significantly higher than that of other diseases(P<0.05).[Conclusion]Preoperative comorbidities are independent factors affecting abdominal complications of patients after minimally invasive surgery.