腹腔镜下毕Ⅱ胃癌根治术后并发空肠梗阻等并发症的危险因素分析与处理

Risk factors analysis and treatment of postoperative complications after laparoscopic radical gastrectomy

摘要:

目的??分析腹腔镜下毕Ⅱ胃癌根治术后空肠梗阻等并发症的危险因素及处理方法。方法?对117例胃癌患者手术治疗前后的临床资料进行分析，并对术后发生并发症可能的危险因素进行评估。结果?腹腔镜下毕Ⅱ胃癌根治术后并发症包括切口感染、肺部感染或胸腔积液、腹腔感染和空肠梗阻吻合口瘘，发生率为35.04%（41/117），手术方式、手术时间、胃管留置时间、术后生活习惯与手术后并发症相关。结论?腹腔镜下毕Ⅱ胃癌根治术后并发症由多种原因综合引起，除患者素质和病变因素外，6个危险因素依次为：行全胃切除术、手术时间4 h、术中出血量800 ml、胃管留置时间3 d、长期吸烟以及胸腹联合切口，应重视其围手术期处理。其中胃管留置时间>3 d、胸腹联合切口、长期吸烟以及手术时间>4 h进行回归方程，为术后并发症主要危险因素。

Abstract:

Objective?To analyze the risk factors and treatment methods of postoperative complications after laparoscopic radical gastrectomy.?Methods?Clinical data of 117 patients with gastric cancer before and after operation were evaluated, and the possible risk factors of postoperative complications were evaluated.?Results?Laparoscopic Billroth Ⅱ gastric cancer radical postoperative complications included incision infection, infection of the lung or pleural or peritoneal infection, obstructed jejunum anastomotic fistula, incidence of 35.04% (41/117), operation method, operation time, the tube indwelling time, postoperative life habits and postoperative complications.?Conclusion?Laparoscopic Billroth Ⅱ gastric cancer radical postoperative complications by a variety of reasons is due to a combination, except for patients with quality and disease factors, 6 risk factors are as follows: the whole stomach resection, surgery time 4 h, hemorrhage 800 ml, gastric tube indwelling time of 3d, long-term smoking, and abdominothoracic incision, more attention should be paid to the perioperative treatment. Surgery time 4 h, gastric tube indwelling time of 3 d, long-term smoking, and abdominothoracic incision are the main risk factors.