腹腔镜胆囊切除术后患者胃肠道功能现状及危险因素的回顾性调查分析

Retrospective Investigation and Analysis of the Current Status and Risk Factors of Gastrointestinal Function in Patients After Laparoscopic Cholecystectomy

目的通过回顾性调查分析腹腔镜胆囊切除术(LC)后患者的胃肠功能现状及危险因素。方法对2021年1月至2024年7月在本院开展LC患者的临床资料开展回顾性调查,依据进食、恶心、呕吐、体格检查及症状维持时间(I-FEED)评分评估其胃肠功能现状并分成胃肠功能恢复良好组和胃肠功能恢复不良组,收集并比较两组临床资料,通过Logistic回归方程,分析影响LC后胃肠功能恢复不良的危险因素。结果共102例LC患者纳入研究,其中31例术后I-FEED评分≥6分者纳入到胃肠功能恢复不良组,占比为30.39%;余71例术后I-FEED评分<6分者划分到胃肠功能恢复良好组,占比为69.61%。两组年龄、手术时间、术后至首次下床活动时间间隔、术后48h血清CCK-A及Lep水平存在统计学差异(P<0.05)。多元Logistic回归模型分析发现,年龄(OR1.147,95%CI 1.096~1.201)、手术时间(OR 9.098,95%CI 4.789~17.285)、术后至首次下床活动时间间隔(OR 6.749,95%CI 3.252~14.006)、术后48 h血清CCK-A水平(OR 5.192,95%CI 4.075~12.574)及术后48 h血清Lep水平(OR 1.785,95%CI 1.426~11.899)均为LC后患者胃肠功能恢复不良的危险因素。结论LC后有部分患者胃肠功能恢复不佳,且年龄、手术时间、术后至首次下床活动时间间隔、术后48h血清CCK-A及Lep水平能影响其术后胃肠功能,需要临床结合上述因素采取有效干预措施,以促进其胃肠功能恢复,确保其预后。

Objective To analyze the current status and risk factors of gastrointestinal function in patients after laparoscopic cholecystectomy(LC)by retrospective investigation.Methods A retrospective survey was conducted on the clinical data of patients who underwent LC from January 2021 to July 2024 in our hospital,and the current status of gastrointestinal function was evaluated according to the scores of intake,nausea,vomiting,physical examination,and symptom maintenance time(I-FEED),and they were divided into the group with good recovery of gastrointestinal function and the group with poor recovery of gastrointestinal function,and clinical data of these two groups were collected and compared,and the statistically significant differences in the univariate analysis were brought into the Logistic regression equation to analyze the risk factors affecting the poor recovery of gastrointestinal function after LC.Results A total of 102 LC patients were included in the study,of which 31 cases with postoperative I-FEED score≥6 were included in the group of poor gastrointestinal function recovery,accounting for 30.39%,and the remaining 71 cases with postoperative I-FEED score<6 were classified into the good group of good gastrointestinal function recovery group,accounting for 69.61%.There were statistical differences between the two groups in age,operation time,time interval from postoperative to first mobilization,and serum CCK-A and Lep levels at 48 h postoperatively(P<0.05).Multiple Logistic regression model analysis revealed that age(OR 1.147,95%CI 1.096-1.201),operation time(OR 9.098,95%CI 4.789-17.285),time interval from postoperative to first mobilization(OR 6.749,95%CI 3.252-14.006),and postoperative 48 h serum CCK-A level(OR 5.192,95%CI 4.075-12.574)and 48 h postoperative serum Lep level(OR 1.785,95%CI 1.426-11.899)were risk factors for poor recovery of gastrointestinal function in patients after LC.Conclusions Some patients had poor recovery of gastrointestinal function after LC,and age,operation time,time interval from postoperative to first mobilization,postoperative 48-h serum CCK-A and Lep levels could affect their postoperative gastrointestinal function,which need to be clinically combined with the above factors to take effective interventions in order to promote the recovery of their gastrointestinal function and ensure their prognosis.