胃癌根治术后患者并发症发生情况及其影响因素分析

Aanlysis of Complications and Its Influencing Factors in Patients after Radical Resection of Gastric Cancer

目的:分析胃癌根治术后患者并发症发生情况,探讨胃癌根治术后患者并发症发生的影响因素。方法:回顾性分析广西医科大学附属肿瘤医院胃肠外科2011年1月-2017年12月619例行胃癌根治术患者的临床资料,根据术后是否发生并发症将患者分为并发症组和无并发症组,使用Clavien-Dindo并发症分级系统对术后并发症进行分级,并分析并发症发生的影响因素。结果:619例患者,96例(15.5%)发生术后并发症,术后肺部感染较为多见,且多为Clavien-Dindo Ⅱ级并发症,占比62.50%(60/96),Ⅲ级以上严重并发症比例为27.08%(26/96)。单因素分析结果显示,两组年龄、术前合并基础疾病、肿瘤直径、术中出血量、手术时间、术前T分期、联合器官切除比较,差异均有统计学意义(P<0.05)。多因素分析提示年龄>70岁、出血量>500 mL、联合切除器官均为胃癌根治术后患者并发症发生的独立危险因素(P<0.05)。结论:胃癌根治术后患者并发症以肺部感染较为多见,年龄>70岁、出血量>500 mL、联合切除器官均为胃癌根治术后患者并发症发生的独立危险因素。

Objective:To analyze the occurrence of complications in patients after radical gastrectomy of gastric cancer,and to explore the influencing factors of complications in patients after radical gastrectomy of gastric cancer.Method:A retrospective analysis was made on 619 patients who underwent radical gastrectomy of gastric cancer from January 2011 to December 2017 in the Gastrointestinal Surgery Department of the Affiliated Tumor Hospital of Guangxi Medical University.The patients were divided into the complications group and the non-complications group according to the postoperative complications.Clavien-Dindo complication classification system was used to grade the postoperative complications,and the influencing factors of complications were analyzed.Result:Among 619 patients,96 cases (15.5%) had postoperative complications,postoperative pulmonary infection was more common,most of which were Clavien-Dindo Ⅱ grade complications,accounting for 62.50% (60/96),the proportion of serious complications above grade Ⅲ was 27.08% (26/96).Univariate analysis showed that there were significant differences between two groups in age,preoperative combined basic diseases,tumor diameter,intraoperative bleeding,operation time,preoperative T-stage and combined organ resection (P<0.05).Multivariate analysis suggested that age >70 years old,intraoperative bleeding >500 mL and combined organ resection were independent risk factors for complications in patients after radical gastrectomy of gastric cancer (P<0.05).Conclusion:Pulmonary infection is the most common complication in patients after radical gastrectomy of gastric cancer.Age >70 years old,bleeding volume >500 mL and combined organ resection were independent risk factors for complications in patients after radical gastrectomy of gastric cancer.