胃癌根治术后并发胆囊炎的相关影响因素分析

[目的]探讨胃癌外科根治术患者术后并发胆囊炎的影响因素.[方法]选取2011年5月至2016年4月本院收治的180例胃癌外科根治术患者的临床资料,对入选的研究对象进行随访调查,根据术后1个月是否并发胆囊炎将其分为观察组(n=59,术后并发胆囊炎者)和对照组(n=121,术后未并发胆囊炎者),对两组患者临床资料进行比较分析,并对具有统计学差异的单因素进行Logistic多因素回归分析.[结果]观察组与对照组患者在空腹血糖是否异常、手术方式的选择、是否进行No.8a淋巴结清扫和No.12淋巴结清扫方面比较,差异具有统计学意义(P<0.05).空腹血糖异常、手术方式的选择、是否进行No.8a淋巴结清扫和No.12淋巴结清扫是影响胃癌术后患者病发胆囊炎的独立危险因素(P<0.05).[结论]术前伴有空腹血糖异常或需进行全胃切除术的患者,应密切观察术后是否并发胆囊炎,而对于无上述情况的患者,则须在手术清扫淋巴结的过程中注意对相关神经的保护,尽可能的减少损伤,维持术后胆囊的正常功能,进而有效降低术后胆囊炎的发生率.

Analysis of Related Factors of Cholecystitis after Radical Gastrectomy for Gastric Cancer

[Objective]To investigate the influencing factors of postoperative cholecystitis in patients undergoing radical gastrectomy for gastric cancer.[Methods]Clinical data of 180 cases of radical gastrectomy for gastric cancer treated in our hospital from May 2011 to April 2016 were selected.The selected subjects were followed up and divided into observation group 1 month after operation (n=59, cholecystitis complicated) and control group (n=121, without cholecystitis after operation complication).The clinical data of the two groups were compared and analyzed.The Logistic regression analysis of single factor with statistical difference was carried out.[Results]The difference in the fasting blood glucose abnormalities, the choice of surgical methods, whether No.8a lymph node dissection and No.12 lymph node dissection were compared between the observation group and the control group, the difference was statistically significant (P<0.05).The abnormality of fasting blood glucose, the choice of operation mode, whether No.8a lymph node dissection and No.12 lymph node dissection were the independent risk factors for postoperative cholecystitis in patients with gastric cancer (P<0.05).[Conclusion]Patients with preoperative fasting glucose abnormalities or those requiring total gastrectomy should be closely observed for postoperative cholecystitis.For patients without these conditions, care must be taken to protect the associated nerve during surgical dissection of the lymph nodes so to reduce injury as much as possible and maintain the normal function of the gallbladder after surgery, thus effectively reduce the incidence of postoperative cholecystitis.