食管癌术后肠内营养胃潴留的危险因素及预防措施

Risk factors and targeted precaution of gastric retention in patients after esophageal cancer surgery receiving enteral nutritional

目的探讨食管癌术后肠内营养胃潴留的危险因素及针对性预防措施。方法回顾性分析165例食管癌术后肠内营养发生胃潴留情况和发生的时间,采用单因素和多因素分析方法对可能影响胃潴留的因素进行调查和分析。结果食管癌术后肠内营养治疗的患者中胃潴留的发生率为21.21%。采用χ2检验或t检验对影响胃潴留的因素进行筛选,结果发现,低血压、低钾血症、便秘、高血糖、感染、电解质紊乱是食管癌患者术后肠内营养胃潴留发生的影响因素(P<0.05)。进一步采用多因素Logistic回归分析,发现高血糖、低钾血症、便秘、电解质紊乱是食管癌术后肠内营养胃潴留的危险因素(P<0.05),有高血糖、低血压、便秘和电解质紊乱的食管癌患者,术后肠内营养胃潴留的风险分别是无高血糖、低血压、便秘和电解质紊乱的食管癌患者的2.517、2.032、1.853、1.677倍。结论食管癌术后肠内营养胃潴留发生率较高,高血糖、低钾血症、便秘、电解质紊乱是术后胃潴留发生的危险因素,临床要采取针对性的预防措施,降低发生风险。

Objective To observe the risk factors and targeted precaution of gastric retention in patients after esophageal cancer surgery receiving enteral nutritional.Methods Retrospective analysis of the incidence and time of enteral nutrition in 165 cases after esophageal cancer surgery were performed.The data were compared using single factor and multivariate analysis methods to investigate and analyze the factors that may affect gastric retention.Results The incidence of gastric retention in patients after esophageal cancer operation receiving enteral nutrition was 21.21%.Chi-square test or t-test was used to screen the relevant factors of gastric retention.The results found that the main related factors were hypotension,hypokalemia,constipation,hyperglycemia,infection,electrolyte disturbances(P<0.05).Furthermore,multivariate analysis using logistic regression analysis found that hyperglycemia,hypokalemia,constipation,and electrolyte disturbance were risk factors of postoperative gastric retention in patients with esophageal cancer after enteral nutrition(P<0.05).Conclusion The incidence is high of gastric retention after esophageal cancer surgery receiving enteral nutritional.Hyperglycemia,hypokalemia,constipation,and electrolyte disturbances were the risk factors of postoperative gastric retention.It is necessary to take the precaution to reduce the risk.