胰十二指肠切除术后胃肠道功能恢复的相关因素分析

Analysis of related factors of gastrointestinal function recovery after undergoing pancreaticoduodenectomy

目的探讨影响胰十二指肠切除术后胃肠道功能恢复的相关因素,为制定护理对策提供参考依据。方法选取2017年12月—2020年12月在医院接受胰十二指肠切除术的60例患者作为研究对象,根据患者术后胃肠道功能恢复时间将其分为两组,其中胃肠道恢复时间≤7 d者纳入正常组(n=30),胃肠道恢复时间>7 d者纳入较差组(n=30)。采用问卷调查法收集两组患者临床资料,并对其进行单因素分析、多因素Logistic回归分析及接收者操作特性曲线(ROC)分析。结果单因素分析显示,术中出血量、术中补液量、手术时间、疲劳量表(FS-14)评分、胃肠道疾病既往史及腹腔积液史为影响胰十二指肠切除术后患者胃肠道功能恢复的相关因素(P<0.05);多因素Logistic回归分析显示,术中出血量、术中补液量、FS-14评分及手术时间为胰十二指肠切除术后患者胃肠道功能恢复的影响因素(P<0.05);ROC曲线分析结果显示,术中出血量>3172.70 ml、术中补液量>4939.77 ml、FS-14评分>9分、手术时间>3.16 h、有腹腔积液史及有胃肠道疾病既往史为影响患者术后胃肠道功能恢复的主要因素(P<0.05)。结论阻碍胰十二指肠切除术后患者胃肠道功能恢复的因素众多,针对术中出血量>3172.70 ml、术中补液量>4939.77 ml、FS-14评分>9分、手术时间>3.16 h以及有腹腔积液史和胃肠道疾病既往史的患者,积极开展护理干预,对促进患者术后胃肠道功能快速恢复具有重要意义。

Objective To explore the relevant factors af fecting the recovery of gastrointestinal function after pancreaticoduodenectomy was as the study subject,and to provide reference for formulating nursing strategies.Methods A total of 60 patients who underwent pancreaticoduodenectomy in the hospital from December 2017to December 2020 were selected as the study objects.The patients were divided into two groups according to the recovery time of gastrointestinal tract function after operation.The patients with gastrointestinal tract recovery time≤7 days were included in the normal group(n=30),and those with gastrointestinal tract recovery time>7days were included in the poor group(n=30).The clinical data of the two groups were collected by questionnaire survey,and univariate analysis,multivariate Logistic regression analysis and receiver operating characteristic curve(ROC)analysis were performed.Results Univariate analysis showed that the intraoperative blood loss,intraoperative fluid replacement volume,operation time,fatigue scale(FS-14)score,past history of gastrointestinal diseases and history of ascites were the related factors af fecting the recovery of gastrointestinal function of patients after pancreaticoduodenectomy(P<0.05).Multivariate Logistic regression analysis showed that the intraoperative blood loss,intraoperative fluid replacement volume,FS-14 score,and operation time were the influencing factors of gastrointestinal function recovery of patients after pancreaticoduodenectomy(P<0.05).The results of ROC curve analysis showed that intraoperative blood loss>3172.70 ml,intraoperative fluid replacement volume>4939.77 ml,FS-14 score>9 points,operation time>3.16 hours,history of ascites,and history of gastrointestinal diseases were the main factors af fecting postoperative gastrointestinal function recovery(P<0.05).Conclusion There were many factors hindered the recovery of gastrointestinal function in patients after pancreaticoduodenectomy.For patients with intraoperative blood loss>3172.70 ml,intraoperative fluid replacement volume>4939.77 ml,FS-14 score>9points,operation time>3.16 hours,and patients with a history of ascites and gastrointestinal diseases,we actively carried out nursing interventions,It was of great significance to promote the rapid recovery of postoperative gastrointestinal function in patients.