高龄胃十二指肠术后患者发生胃瘫综合征的高危因素

目的探讨高龄胃十二指肠术后患者发生胃瘫综合征(PGS)的高危因素,以便更好地加强防护。方法选择2018年1月—2019年8月医院收治的108例高龄胃十二指肠手术患者,根据是否发生PGS,将48例高龄胃十二指肠术后发生PGS患者作为病例组,未发生PGS的高龄胃十二指肠术后患者60例作为对照组,比较两组患者的精神状况、术前访视、术前营养状况、胃肠吻合方式、手术时间、术后高血糖、术后腹腔并发症、肠内营养开始时间、术后肠外营养时间,分析影响PGS发生的危险因素。结果单因素分析显示,精神状况、术前访视、术前营养不良、手术时间、术后高血糖、术后腹腔并发症、肠内营养开始时间、术后肠外营养时间是影响胃十二指肠术后发生PGS的因素(P<0.05)。多因素Logistic回归分析显示,术后高血糖、术后腹腔并发症、肠内营养开始时间为影响胃十二指肠术后发生PGS的独立危险因素(P<0.05)。结论高龄胃十二指肠术后PGS的发生是由多种因素共同作用的结果,术后高血糖、术后腹腔并发症及肠内营养开始时间长是导致术后发生PGS的主要危险因素。

High risk factors of gastroparesis syndrome occurred in elderly patients after the gastroduodenal operation

Objective To explore the high risk factors of the postsurgical gastroparesis syndrome(PGS)in elderly patients underwent the gastroduodenal operation,in order to strengthen the prevention preferably.Methods To select 108 elderly patients underwent the gastroduodenal surgery in the hospital from January 2018 to August 2019 as the study objects,according to the occurrence of the PGS,48 elderly patients underwent the gastroduodenal operation occurred the PGS were set as the case group,and 60 elderly patients underwent the gastroduodenal operation without the PGS were set as the control group,mental status,preoperative visit,preoperative nutritional status,gastrointestinal anastomosis method,operation time,postoperative hyperglycemia,postoperative abdominal complications,starting time of nutrition,postoperative parenteral nutrition time were compared between two groups,the high risk factors affecting the occurrence of PGS were analyzed.Results Univariate analysis showed that,mental statue,preoperative visit,preoperative malnutrition,operation time,postoperative hyperglycemia,postoperative abdominal complications,nutritional onset time,postoperative parenteral nutrition time were the influencing factors of the occurrence of PGS after the the gastroduodenal operation(P<0.05).Multivariate Logistic regression analysis showed that,postoperative hyperglycemia,postoperative abdominal complications,nutritional onset time were the independent risk factors of the occurrence of PGS after the the gastroduodenal operation(P<0.05).Conclusion The occurrence of PGS in elderly patients after gastroduodenectomy was resulted by the combined effect of various factors,postoperative hyperglycemia,postoperative abdominal complications and long-term enteral nutrition were the main risk factors of the occurrence of PGS after the the gastroduodenal operation.