超重患者与体重指数正常患者腹腔镜胃癌根治术后疗效的倾向性评分匹配分析

Propensity score matching analysis of the curative effect after laparoscopic radical gastrectomy between overweight patients and patients with normal body mass index

目的探究腹腔镜胃癌根治术治疗超重患者与体重指数(BMI)正常患者的术后疗效。方法选取189例胃癌患者,其中BMI正常患者106例,超重患者83例,进一步采用倾向性评分匹配分析分为BMI正常组与超重组,每组68例。比较两组患者临床特征、手术一般情况、术后恢复情况及并发症发生情况。结果按倾向性评分匹配后,两组患者各临床特征比较,差异均无统计学意义(P﹥0.05)。BMI正常组患者进流食时间、通气时间、手术时间、引流管拔除时间、首次肛门排气时间、术后住院时间均短于超重组,术中出血量、住院总费用均少于超重组,术后并发症发生率低于超重组,差异均有统计学意义(P﹤0.05)。结论超重患者在接受腹腔镜胃癌根治术时,相较于BMI正常患者,面临着更高的手术风险、更长的手术时间、更多的术中出血量、更长的术后恢复时间以及更高的术后并发症发生率。

Objective To investigate the postoperative efficacy of laparoscopic radical gastrectomy in overweight patients and patients with normal body mass index(BMI).Method A total of 189 patients with gastric cancer were enrolled,including 106 patients with normal BMI and 83 overweight patients.According to propensity score matching,the patients were divided into normal BMI group and overweight group,with 68 cases in each group.The clinical characteristics,general surgical conditions,postoperative recovery and complications were compared between the two groups.Result After propensity score matching,there were no significant differences in clinical characteristics between the two groups(P>0.05).The time of liquid food intake,ventilation time,operation time,drainage tube removal time,first anal exhaust time and postoperative hospital stay in the normal BMI group were shorter than those in the overweight group,the intraoperative blood loss and total hospitalization cost were less than those in the overweight group,and the incidence of postoperative complications was lower than that in the overweight group,the differences were statistically significant(P<0.05).Conclusion Compared with patients with normal BMI,overweight patients undergoing laparoscopic radical gastrectomy face higher surgical risk,longer operation time,more intraoperative blood loss,longer postoperative recovery time and higher incidence of postoperative complications.