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胃癌淋巴结清除术后乳糜漏影响因素及应对策略
引用本文:徐伟,翟博,王东.胃癌淋巴结清除术后乳糜漏影响因素及应对策略[J].中国现代普通外科进展,2010,13(5):364-366.
作者姓名:徐伟  翟博  王东
作者单位:哈尔滨医科大学附属第四医院,普外科,黑龙江,哈尔滨,150001
摘    要:目的:探讨胃癌淋巴结清除术后乳糜漏的影响因素及防治措施。方法:搜集631例胃癌患者的临床资料,采用χ2检验、单因素分析及Logistic回归分析的方法研究性别、年龄、门静脉高压、术后第1日白蛋白水平、胃切除范围、淋巴结清除及淋巴结转移范围、超声刀应用对乳糜漏的影响。结果:术后第1日高白蛋白水平升高和应用超声刀清除淋巴结是乳糜漏保护性相关因素(P〈0.05)。结论:应用超声刀可明显降低术后乳糜漏发生率,禁食、全胃肠外营养及应用生长抑素是有效治疗手段。

关 键 词:胃切除术  胃肿瘤  乳糜性腹水  淋巴结切除术

Risk factors and treatment of lymphatic fistulas after the radical operation of gastric cancer
XU wei,ZHAI Bo,WANG Dong.Risk factors and treatment of lymphatic fistulas after the radical operation of gastric cancer[J].Chinese Journal of Current Advances in General Surgery,2010,13(5):364-366.
Authors:XU wei  ZHAI Bo  WANG Dong
Institution:Department of Gerenal Surgery,the Fourth Hospital of Harbin Medical University(Harbin 150001,China)
Abstract:Objective:To study the risk factors and treatment of lymphatic fistulas after the radical operation of gastric cancer.Methods:Observed the clinical data of 631 cases after the radical operation of gastric cancer that had been received in our hospital from February 1998 to February 2008.Multiple factor analysis with logistic regression was performed for the risk factors.Results:The level of post-operative serum albumin on the first day and Ultrasonically activated shears are protective facrors against lymphatic fistulas(P0.05).Conclusions:Ultrasonically activated shears can reduce lymphatic fistulas.Fasting,total parenteral nutrition and octreotide are effective for the treatment of lymphatic fistulas.
Keywords:Gastrectomy·Stomach neoplasms·Chylous ascites·Lymph node excision
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