专题研究(Monographic Study)

大肠癌根治术后胃瘫综合征的临床分析

Published at: 2016年第25卷第4期

陈宏刚 1 , 陈勇 1 , 易深根 1 , 余丹 1
1 中南大学湘雅二医院 普通外科,湖南 长沙 410011
通讯作者 勇 陈 Email: zndxxyeyy@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.04.008
基金:

摘要

目的:探讨大肠癌术后发生胃瘫综合征(PGS)及危险因素及诊疗方法。方法:收集2013年1月—2014年9月行手术治疗的大肠癌患者806例临床资料,对PGS发生的影响因素行统计学分析。结果:全组PGS的发生率为1.36%(11/806),分别发生于7例右半结肠癌患者(63.6%),3例左半结肠癌患者(27.3%),1例直肠癌患者(9.1%)。单因素分析显示,术前血糖水平(P=0.002)、术前电解质紊乱与否(P=0.023)、术前肠梗阻与否(P=0.009)、术后进食时间(P=0.018)与PGS的发生有关;多因素Logistic回归分析显示,术前血糖水平(P=0.002)与术后进食时间(P=0.028)是PGS发生的独立危险因素。结论:PGS是多因素引起的胃功能性紊乱,应予以综合治疗措施。控制好患者血糖水平,根据患者围手术期一般情况适当延迟进食时间有利于减少大肠癌根治术后PGS的发生。


Clinical analysis of postoperative gastroparesis syndrome after radical resection of colorectal cancer

Abstract

Objective: To investigate the risk factors for postoperative gastroparesis syndrome (PGS) after colorectal cancer surgery and its diagnostic and treatment strategies. Methods: Clinical data of 806 patients undergoing radical resection of colorectal cancer from January 2013 to September 2014 were collected. The influential factors for occurrence of PGS were statistically analyzed. Results: The incidence of PGS of the whole group was 1.36% (11/806), which occurred in 7 cases with right colon cancer (63.6%), 3 cases with left colon cancer (27.3%) and one case with rectal cancer (9.1%). Univariate analysis indicated that the related factors for PGS included the preoperative blood sugar level (P=0.002), presence or absence of preoperative electrolyte imbalance (P=0.023), having or not having preoperative intestinal obstruction (P=0.009), and time to first postoperative food intake (P=0.018). Multivariate Logistic regression analysis showed that the preoperative blood sugar level (P=0.002) and time to first postoperative food intake (P=0.028). were independent risk factors for PGS. Conclusion: PGS is a functional abnormality of the stomach caused by various factors, so comprehensive interventions should be implemented. Effective blood glucose control and appropriately prolonging the time to postoperative food consumption may be helpful to reduce the occurrence of PGS following radical resection of colorectal cancer.


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引用

引用本文: 宏刚 陈, 勇 陈, 深根 易, 丹 余. 大肠癌根治术后胃瘫综合征的临床分析[J]. 中国普通外科杂志, 2016, 25(4): 510-517.
Cite this article as: CHEN Honggang, CHEN Yong, YI Shen'gen, YU Dan . Clinical analysis of postoperative gastroparesis syndrome after radical resection of colorectal cancer [J]. Chin J Gen Surg, 2016, 25(4): 510-517.