老年腹腔镜胃癌患者术后早期肠内营养不耐受的高危因素分析

High risk factors for early postoperative enteral nutrition intolerance in elderly patients with laparoscopic gastric cancer

[目的]分析老年腹腔镜胃癌患者术后早期肠内营养不耐受的高危因素。[方法]回顾性分析经病理确诊且均行早期肠内营养支持的286例老年腹腔镜胃癌手术患者的临床资料。应用单因素分析老年腹腔镜胃癌患者术后早期肠内营养不耐受的危险因素,对有差异的统计学资料纳入多因素Logistic回归分析。[结果]286例老年腹腔镜胃癌手术患者中,178例发生术后早期肠内营养不耐受(不耐受组),占比62.24%;耐受组108例,占37.76%。单因素分析显示,2组患者性别、年龄、TNM分期、BMI、合并基础疾病、胃癌根治方法、手术时间、术中出血量和麻醉时间上相比,差异无统计学意义(P>0.05);而2组患者在营养途径、肠内营养开始时间及使用营养泵上对比,差异有统计学意义(P<0.05)。多因素Logistic分析表明,营养途径、肠内营养开始时间及使用营养泵为影响老年腹腔镜胃癌患者术后早期肠内营养不耐受的危险因素。[结论]老年腹腔镜胃癌患者术后早期肠内营养不耐受的危险因素为营养途径、肠内营养开始时间和使用营养泵。

[Objective]To analyze the high-risk factors for early postoperative enteral nutrition intolerance in 178 elderly patients with laparoscopic gastric cancer,so as to provide a reference for clinical diagnosis and treatment.[Methods]We retrospectively reviewed the clinical data of 286 elderly laparoscopic gastric cancer surgery patients who were admitted to our hospital between January 2019 and January 2022,and the patients were all pathologically confirmed and supported by military star early enteral nutrition.General and clinical data of the patients were collected.Univariate analysis of risk factors for intolerance to early postoperative enteral nutrition in elderly gastric cancer patients with laparoscopic operation was performed,then multivariate logistic analysis was used to further regression analysis with the above-mentioned differential statistical data to finally explore the risk factors.[Results]Totals of 286 elderly patients undergoing laparoscopic gastric cancer surgery,178 developed early postoperative enteral nutrition intolerance,accounting for 62.24%.Univariate analysis showed that there were no significant differences between the two groups in terms of gender,age,TNM stage,BMI,comorbid underlying diseases,radical approach to gastric cancer,operative time,intraoperative blood loss and anesthesia time(P>0.05).However,there were significant differences between the two groups regarding the route of nutrition,the time of starting enteral nutrition and the use of nutrition pumps(P<0.05).The inclusion of the above univariate analysis with statistical differences in multivariate logistic analysis showed that the route of nutrition,the time of initiation of enteral nutrition and the use of nutrition pumps were risk factors for early postoperative enteral nutrition intolerance in elderly patients with laparoscopic gastric cancer.[Conclusion]Risk factors for intolerance to enteral nutrition in the early postoperative period in elderly laparoscopic gastric cancer patients are nutritional route,timing of initiation of enteral nutrition and use of nutrition pumps,and special attention should be paid to such situations clinically for prevention.