腹腔镜下根治性胃癌切除术后并发肺炎的危险因素分析

Analysis of risk factors of postoperative pneumonia for the patient who underwent laparoscopic radical gastrectomy

目的:探究腹腔镜下根治性胃癌切除术后并发肺炎的危险因素。方法:收集2017年9月1日至2019年5月1日期间在我院行腹腔镜下根治性胃癌切除术的患者。详细统计所有患者入院后一般资料、病理资料、手术及术后相关资料,将出现肺部感染患者与未出现肺部感染患者分为两组,先通过单因素分析得出影响腹腔镜下根治胃癌切除术后患者肺部感染的危险因素。进一步将有意义的因素纳入多因素分析,得出患者的独立危险因素。结果:本研究共纳入319例患者,其中术后发生肺部感染患者有13例。单因素分析提示术前是否合并有糖尿病、术前是否有肺部疾病、是否有肺功能不全、是否有术前低蛋白血症或者贫血、手术方式、手术时间、是否入住ICU治疗、是否有术后护理协助患者排痰为术后并发肺部感染的危险因素。多因素分析发现术前是否合并有糖尿病、既往是否有肺部疾病病史、手术时间为腹腔镜下根治性胃癌切除术后并发肺部感染的独立危险因素。且术后并发肺部感染与不良预后相关。结论:胃癌术后并发肺部感染的危险因素存在于围术期每个环节,医护人员需从多个角度出发,积极干预,预防术后并发肺部感染的可能。

Objective:To explore the risk factors for postoperative pneumonia for the patient who underwent laparoscopic radical gastrectomy.Methods:The patients who underwent laparoscopic radical gastrectomy during September 1,2017 to May 1,2019 were collected.Then the general data,pathological data,surgery and postoperative related information was collected for analysis.Patients were divided into two groups by whether they acquired postoperative pneumonia.The risk factors were analyzed by univariate and multivariate analyses to find out the independent factors for postoperative pneumonia.Results:A total of 319 patients were included in the study,of which 13 were patients with lung infection after surgery.Single-factor analysis suggested diabetes,preoperative lung disease,lung insufficiency,preoperative hypo-proteinemia or anemia,surgery method,surgery time,stay in ICU treatment,postoperative care to assist patients with sputum contributed as risk factors for postoperative concurrent lung infection.Multivariateanalysis revealed that preoperative complications of diabetes,previous history of lung disease,and operation time were independent risk factors for pulmonary infection after laparoscopic radical gastrectomy.And postoperative pulmonary infection was associated with poor prognosis.Conclusion:The risk factors for postoperative lung infections in gastric cancer were at every stage of the perioperative period.Nursing staff must actively intervene from multiple perspectives to prevent the possibility of postoperative complications.