胃癌患者术后反流性食管炎发生状况及影响因素

Occurrence and influencing factors of reflux esophagitis in patients with gastric cancer after operation

目的观察胃癌患者术后反流性食管炎发生状况,并对术后反流性食管炎发生的影响因素进行分析,指导胃癌患者术后反流性食管炎的预防。方法前瞻选取2018年1月至2019年10月信阳市第四人民医院接受手术治疗的84例胃癌患者作为研究对象,依据患者术后有无发生反流性食管炎分为发生组和未发生组,设计一般情况调查表调查患者基线资料,经单因素与多因素分析找出胃癌患者术后发生反流性食管炎的影响因素。结果 84例胃癌患者中,18例患者术后发生反流性食管炎,发生率为21.43%;初步比较发生与未发生患者基线资料后,将比较差异有统计学意义的变量逐个纳入行单项Logistic回归分析,后将全部变量纳入建立多元回归模型行多因素分析。结果显示,高BMI、近端胃癌根治术、胆囊切除史、消化道重建方式(B-I)均是胃癌患者术后发生反流性食管炎的影响因素(OR>1, P<0.05)。结论胃癌患者术后有较高的反流性食管炎发生风险,可能与患者高BMI、近端胃癌根治术、既往有胆囊切除史、B-I等因素有关,临床应重视有上述风险因素患者的早期合理干预,可能对减少胃癌患者术后反流性食管炎的发生有积极意义。

【Objective】To observe the incidence of reflux esophagitis in patients with gastric cancer after operation,and to analyze the influencing factors of reflux esophagitis after operation,to guide the prevention of reflux esophagitis in patients with gastric cancer after operation.【Methods】Eighty-four patients with gastric cancer who received surgical treatment in our hospital from January 2018 to October 2019 were prospectively selected as the research subjects,they were divided into an occurrence group and a non-occurrence group according to the occurrence of reflux esophagitis in patients after surgery,a general questionnaire was designed to investigate the baseline data of patients,and the influencing factors of reflux esophagitis in patients with gastric cancer after operation were found out by univariate and multivariate analysis.【Results】Among 84 patients with gastric cancer,18 patients developed reflux esophagitis after operation,the incidence rate was 21.43%;after comparing the baseline data of patients with and without occurrence,the variables with statistically significant differences were included one by one,single Logistic regression analysis was performed,and then all variables were included,multiple regression model was established and multi factor analysis was performed.The results showed that high BMI,proximal gastrectomy,history of cholecystectomy and digestive tract reconstruction(B-I)were the influencing factors of reflux esophagitis in patients with gastric cancer after operation(O^R>1,P<0.05).【Conclusion】Patients with gastric cancer have a high risk of reflux esophagitis,which may be related to factors such as high BMI,radical resection of proximal gastric cancer,previous history of cholecystectomy and B-I,the early and reasonable intervention of patients with the above risk factors should be focused on clinically,which may be helpful to reduce the incidence of reflux esophagitis in patients with gastric cancer after surgery.