腹腔镜远端胃癌根治术后肠梗阻发生的影响因素研究

Study on the influencing factors of intestinal obstruction after laparoscopic radical gastrectomy for distalgastriccancer

目的分析腹腔镜远端胃癌根治术(LADG)后肠梗阻发生的影响因素。方法回顾性分析2020年5月至2023年5月行LADG的182例胃癌患者临床资料,根据术后6个月后肠梗阻发生情况分为发生组(n=24例)与未发生组(n=158例)。采用SPSS27.0软件处理数据,单因素、多因素Logistic回归分析影响LADG术后肠梗阻发生的相关因素。P<0.05为差异有统计学意义。结果单因素分析显示,体重指数(BMI)、TNM分期、术前血清前白蛋白水平、术后镇痛方式、术后早期下床活动时间是LADG术后肠梗阻发生的影响因素(P<0.05);多因素Logistic回归分析显示,TNM分期为Ⅲa期、术前低血清前白蛋白、术后静脉自控镇痛泵镇痛、术后早期下床活动时间>48h是LADG术后肠梗阻发生的危险因素(P<0.05)。结论术前TNM分期为Ⅲa期、低血清前白蛋白、术后静脉自控镇痛泵镇痛、术后早期下床活动时间>48h是胃癌患者LADG术后发生肠梗阻的影响因素。

Objective To analyze the influencing factors of intestinal obstruction after laparoscopic radical gastrectomy(LADG).Methods Clinical data of 182 gastric cancer patients who received LADG from May 2020 to May 2023 were retrospectively analyzed.According to the occurrence of intestinal obstruction 6 months after surgery,they were divided into the occurrence group(n=24 cases)and the non-occurrence group(n=158 cases).SPSS 27.0 software was used to process the data,and univariate and multivariate Logistic regression analysis was conducted to analyze the related factors affecting the occurrence of postoperative intestinal obstruction after LADG.P<0.05 was considered statistically significant.Results Univariate analysis showed that body mass index(BMI),TNM stage,preoperative serum prealbumin,postoperative analgesia and early ambulation time were the influencing factors of postoperative ilobstruction in LADG(P<0.05).Multivariate Logistic regression analysis showed that TNM stage II a,preoperative low serum prealbumin,postoperative controlled intravenous analgesia pump analgesia,and early postoperative ambulation time>48 h were risk factors for postoperative intestinal obstruction in LADG(P<0.05).Conclusion PreoperativeTNM stage Ⅲa,low serum prealbumin,postoperative self-controlled intravenous analgesia pump analgesia,and early postoperative ambulation time>48 h are the influential factors for postoperative intestinal obstruction in gastric cancer patients with LADG.