Child胰肠吻合术后功能性胃排空障碍的危险因素分析

    The risk factor analysis of the delayed gastric emptying after Child pancreaticojejunostomy

    • 摘要: 目的:探讨Child胰肠吻合术后功能性胃排空障碍(DGE)的影响因素。方法:对2002~2012年行Child胰肠吻合术的132例患者的临床资料进行回顾性分析。结果:术后DGE 47例,发生率为35.61%;患者DGE发生率在性别、年龄、是否合并高血压、是否合并糖尿病、直接胆红素水平、手术时间、术后早期是否肠内营养间差异均无统计学意义(P0.05),而患者术前WBC水平、白蛋白(ALB)水平、术中出血量、术后有无胰瘘对DGE的发生均有影响(P0.05~P0.01);多因素分析显示,患者ALB与DGE的发生呈负相关关系(OR=0.797,P0.01),术中出血量、手术时间、术后是否胰瘘与DGE的发生呈正相关关系(OR分别为2.275、1.756和2.885)。结论:改善患者营养状态、减少术中出血量、缩短手术时间可减少DGE的发生,术后胰瘘可增大DGE的发生率。

       

      Abstract: Objective: To investigate the risk factors of the delayed gastric emptying( DGE) after child pancreaticojejunostomy( PD). Methods: The clinical data of 132 patients with PD were retrospectively analyzed from 2002 to 2012. Results: The postoperative DGE in 7 cases were found,the incidence rate of which was 35. 61%. The differences of DGE in gender,age,hypertension,diabetes mellitus, direct bilirubin levels,operative time and early postoperative enteral nutrition had no statistical significance( P 0. 05). The preoperative white blood cell levels,ALB levels,intraoperative blood loss and postoperative pancreatic fistula had effects on the incidence of DGE( P 0. 05 to P 0. 01). The multivariate analysis showed ALB and DGE was negatively correlated( P 0. 05),the value of OR was 0. 797. The intraoperative blood loss,operation time,postoperative pancreatic fistula were positively correlated with DGE( P 0. 01),the value of OR were 2. 275,1. 756 and 2. 885,respectively. Conclusions: Improving nutritional status,reducing blood loss,shortening the operation time can reduce the occurrence of DGE,postoperative pancreatic fistula can increase the incidence of DGE.

       

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