摘要
【目的】探讨胃肠道肿瘤患者腹腔镜根治术后化疗发生肠梗阻的影响因素。【方法】162例行腹腔镜根治术及术后化疗的胃肠道肿瘤患者,术后随访30 d并统计肠梗阻发生率,采用单因素及Logistic多因素分析肠梗阻发生的影响因素。【结果】162例患者中,30 d内发生肠梗阻13例(肠梗阻组),未发生肠梗阻149例(非肠梗阻组),肠梗阻发生率为8.02%。肠梗阻组男性、年龄≥70岁、肿瘤分期Ⅲ~Ⅳ期、术前低蛋白血症、术前肠梗阻、腹部手术史、手术时间≥2 h、联合脏器切除、化疗后应用止吐药物、首次排气时间≥48 h、首次排便时间≥72 h、肠鸣音恢复时间≥72 h以及术后进食时间≥96 h占比高于非肠梗阻组(P<0.05)。Logistic回归分析显示,性别、年龄、肿瘤分期、术前低蛋白血症、腹部手术史、联合脏器切除、化疗后应用止吐药物、首次排气时间、首次排便时间、肠鸣音恢复时间及术后进食时间均是胃肠肿瘤患者术后化疗发生肠梗阻的影响因素(P<0.05)。【结论】胃肠道肿瘤患者腹腔镜根治术后化疗发生肠梗阻受性别、年龄、肿瘤分期、术前低蛋白血症、腹部手术史、联合脏器切除、化疗后应用止吐药物等多种因素影响,临床应积极采取相应预防措施,尽可能减少肠梗阻的发生。
【Objective】To investigate the factors influencing the occurrence of intestinal obstruction in patients with gastrointestinal tumors following laparoscopic radical surgery and subsequent chemotherapy.【Methods】A total of 162 patients who underwent laparoscopic radical surgery and postoperative chemotherapy for gastrointestinal tumors were followed for 30 days postoperatively.The incidence of intestinal obstruction was recorded.Univariate and multivariate Logistic regression analyses were performed to identify factors associated with the development of intestinal obstruction.【Results】Among the 162 patients,13 cases developed intestinal obstruction within 30 days postoperatively,yielding an incidence rate of 8.02%.Factors showing significantly more prevalent in the obstruction group compared to the non-obstruction group included:male gender,age≥70 years,tumor stageⅢ-Ⅳ,preoperative hypoproteinemia,history of preoperative intestinal obstruction,history of abdominal surgery,operative time≥2 hours,combined organ resection,use of antiemetic drugs post-chemotherapy,time to first flatus≥48 hours,time to first defecation≥72 hours,time to recovery of bowel sounds≥72 hours,and time to postoperative feeding≥96 hours(P<0.05).Multivariate logistic regression analysis identified gender,age,tumor stage,preoperative hypoproteinemia,history of abdominal surgery,combined organ resection,use of antiemetic drugs post-chemotherapy,time to first flatus,time to first defecation,time to recovery of bowel sounds,and time to postoperative feeding as significant factors influencing the occurrence of intestinal obstruction(P<0.05).【Conclusion】The development of intestinal obstruction following chemotherapy after laparoscopic radical surgery in patients with gastrointestinal tumors is influenced by multiple factors,including gender,age,tumor stage,preoperative hypoproteinemia,history of abdominal surgery,combined organ resection,and use of antiemetic drugs post-chemotherapy.Clinicians should proactively implement preventive measures to minimize the risk of intestinal obstruction.
作者
黄元哲
张定喜
邹浩洋
HUANG Yuanzhe;ZHANG Dingxi;ZOU Haoyang(Department of General Surgery,Xuchang People's Hospital,Xuchang Henan 461000)
出处
《医学临床研究》
2025年第6期974-977,共4页
Journal of Clinical Research
关键词
胃肠肿瘤
腹腔镜检查
药物疗法
联合
肠梗阻
Gastrointestinal Neoplasms
Laparoscopy
Drug Therapy,Combination
Intestinal Obstruction
