子宫内膜癌子宫全切术后发生肠梗阻的危险因素分析

Risk factors of intestinal obstruction after total hysterectomy for endometrial cancer

目的分析子宫内膜癌子宫全切术后发生肠梗阻的危险因素,为预防术后肠梗阻的发生提供重要依据。方法选取2017年8月至2021年8月于江苏省淮安市第一人民医院行子宫全切术的子宫内膜癌患者110例,按照术后是否发生肠梗阻,将其分为未发生组和发生组,分析子宫内膜癌子宫全切术后发生肠梗阻的危险因素。结果110例患者中,9例发生肠梗阻,发生率为8.18%。两组体重指数、盆腔手术史、既往痛经史、盆腔粘连、阿片类应用、手术方式、术后血钾、盆腔感染、手术时间、术后禁食时间比较,差异有统计学意义(P<0.05)。盆腔粘连(OR=2.630,95%CI:1.175~5.886)、阿片类应用(OR=2.396,95%CI:1.397~4.108)、术后血钾(OR=2.373,95%CI:1.183~4.758)为子宫内膜癌子宫全切术后肠梗阻发生的独立影响因素。结论盆腔粘连、阿片类应用及术后血钾水平为导致肠梗阻发生的重要因素,临床应加强对上述因素的重视,采取相应预防措施的同时,降低肠梗阻的发生,促进术后康复。

Objective To analyze the risk factors of intestinal obstruction after total hysterectomy for endometrial cancer,so as to provide an important basis for the prevention of postoperative intestinal obstruction.Methods A total of 110 patients with endometrial cancer who underwent hysterectomy in Huai’an First People’s Hospital of Jiangsu Province from August 2017 to August 2021 were selected.They were divided into the non-occurrence group and the occurrence group.The risk factors of intestinal obstruction after total hysterectomy for endometrial cancer were analyzed.Results Among the 110 patients,9 patients had intestinal obstruction,the incidence rate was 8.18%.There were significant differences in body mass index,history of pelvic surgery,history of dysmenorrhea,pelvic adhesion,opioid application,operation method,postoperative blood potassium,pelvic infection,operation time,and postoperative fasting time between the two groups(P<0.05).Pelvic adhesion(OR=2.630,95%CI:1.175-5.886),opioid application(OR=2.396,95%CI:1.397-4.108),postoperative blood potassium(OR=2.373,95%CI:1.183-4.758)were independent influencing factor of intestinal obstruction after total hysterectomy for endometrial cancer.Conclusion Pelvic adhesion,opioid application,and postoperative blood potassium level are important factors leading to the occurrence of intestinal obstruction.Clinical attention should be paid to the above factors,and corresponding preventive measures should be taken to reduce the occurrence of intestinal obstruction and promote postoperative rehabilitation.