老年胃癌患者术后早期肠内营养不耐受的高危因素分析

Risk factors of early enteral nutrition intolerance in elderly patients with gastric cancer after operation

[目的]分析老年胃癌患者术后早期肠内营养不耐受的高危因素。[方法]选择行胃癌根治术的老年胃癌患者143例进行早期肠内营养支持方法治疗。用单因素分析影响术后早期肠内营养不耐受相关因素;采用多因素Logistic回归分析影响术后早期肠内营养不耐受高危因素。调查资料包括性别、年龄、TNM分期、体质指数(BMI)、合并基础疾病、营养途径、胃癌根治方法、手术方法、手术时间、术中出血量、麻醉时间、肠内营养开始时间、使用营养泵。[结果]143例中是否发生术后早期肠内营养不耐受患者各89例(不耐受组)、54例(耐受组)。经单因素分析结果显示,2组性别、年龄、TNM分期、BMI、合并基础疾病、营养途径、胃癌根治方法、手术时间、术中出血量和麻醉时间比较均差异无统计学意义(P>0.05);2组手术方法、肠内营养开始时间和使用营养泵比较差异具有统计学意义(P<0.05)。将上述单因素分析差异具有统计学意义的纳入多因素Logistic回归分析显示,手术方法、肠内营养开始时间和使用营养泵为影响术后早期肠内营养不耐受危险因素。[结论]老年胃癌患者术后早期肠内营养不耐受中,手术方法、肠内营养开始时间和使用营养泵为其危险因素。

[Objective]To analyze the high risk factors of early enteral nutrition intolerance in elderly pa-tients with gastric cancer after operation.[Methods]The 143 elderly patients with gastric cancer who un-derwent elective radical gastrectomy in our hospital from March 2017 to March 2019 were selected as the study subjects.All patients received early enteral nutrition support.Univariate analysis was used to analyze the related factors of early enteral nutrition intolerance after operation,and multivariate logistic regression was used to analyze the high risk factors of early enteral nutrition intolerance after operation.Survey data included sex,age,TNM stage,body mass index(BMI),combined with basic diseases,nutritional pathway,radical gastric cancer treatment methods,surgical methods,operation time,intraoperative bleeding volume,anesthesia time,enteral nutrition start time,the use of nutrition pump.[Results]Among 143 cases,there were 89 cases(intolerance group)and 54 cases(tolerance group)of patients with early postoperative enteral nutrition intolerance.The results of univariate analysis showed that there was no significant difference in gender,age,TNM stage,BMI,basic diseases,nutritional pathway,radical gastrectomy,operation time,intr-aoperative bleeding and anesthesia time between the two groups(P>0.05).There were significant differ-ences in operation methods,enteral nutrition start time and nutrition pump use between the two groups.There was statistical significance(P<0.05).The results of logistic regression analysis showed that the risk factors of early enteral nutrition intolerance were operation methods,enteral nutrition start time and nutrition pump use.[Conclusion]The risk factors of early enteral nutrition intolerance in elderly pa-tients with gastric cancer after operation are operation method,enteral nutrition start time and use of nutri-tionpump.