Child胰肠吻合术后功能性胃排空障碍的危险因素分析

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。

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

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.