[1]薛 萍,程智猛,方进博.胰十二指肠切除术后发生胃排空延迟危险因素 的病例对照研究[J].肠外与肠内营养杂志,2020,(02):112-116.[doi:10.16151/j.1007-810x.2020.02.011]
　XUE Ping,CHENG Zhi-meng,FANG Jin-bo.A case-control study on the risk factors for delayed gastric emptying after pancreaticoduodenectomy[J].PARENTERAL & ENTERAL NUTRITION,2020,(02):112-116.[doi:10.16151/j.1007-810x.2020.02.011]
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胰十二指肠切除术后发生胃排空延迟危险因素 的病例对照研究
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2020年02期
页码:
112-116
栏目:
论著
出版日期:
2020-03-10

文章信息/Info

Title:
A case-control study on the risk factors for delayed gastric emptying after pancreaticoduodenectomy
作者:
薛 萍 1; 程智猛 2; 方进博 3
四川大学华西医院，1.中西医结合科；2.肝胆外科；3.护理学院，四川成都 610000
Author(s):
XUE Ping11; CHENG Zhi-meng2;  FANG Jin-bo3
1. Department of Integrated Traditional Chinese and Western Medicine；2. Department of Hepatobiliary Surgery；3.West China School of Nursing ，West China Hospital of Sichuan University, Chengdu 610000, Sichuan, China
关键词:
胰十二指肠切除术 ; 胃排空延迟 ; 危险因素
Keywords:
Delayed gastric emptying;  Risk factors;  Pancreaticoduodenectomy
分类号:
R656.6
DOI:
10.16151/j.1007-810x.2020.02.011
文献标志码:
A
摘要:
目的：通过研究胰十二指肠切除术后出现胃排空延迟病人的临床资料，分析胰十二指肠切除术后发 生胃排空延迟的危险因素，找出降低其胃排空延迟(DGE)发生率的护理对策。 方法：回顾我院行胰十二指肠切除 术的230例病人的病历资料，数据以分类变量的比例表示并对分类变量进行单因素分析，应用Logistic回归模型确 定胰十二指肠切除术后胃排空延迟的影响因素，并参考国内外相关文献报道加以讨论。 结果：单因素分析提示， 术前血清总胆红素(TB)≥300 umol/L、术前血清白蛋白(ALB) < 30 g/L、体质量指数(BMI) < 18.5 kg/m2、再次手术、胰 瘘、胆瘘、腹腔/消化道出血、腹腔感染、术后随机血糖≥11 mmol/L、术后ALB< 30 g/L、术后Hb < 90 g/L是胃排空延 迟发生的危险因素（P< 0.05），Logistic回归多因素分析提示，BMI< 18.5 kg/ m2、术前TB≥ 300 umol/L、术后胆瘘、胰 瘘、腹腔感染、术后持续血糖≥ 11mmol/L、术后ALB< 30 g/L是胃排空延迟发生的危险因素（P< 0.05）。 结论：胰十 二指肠切除术围手术期控制营养不良、高血糖及术后预防胆瘘、胰瘘和腹腔感染的发生是预防DGE的发生的关键。
Abstract:
Objective: By studying the clinical data of patients with pancreaticoduodenectomy, analyze the risk factors of delayed gastric emptying and provide suggestive nursing strategy to reduce the incidence of delayed gastric emptying. Methods: We retrospectively analyzed the clinical data of 230 patients with pancreaticoduodenectomy in our hospital . The data were presented as proportions for categorical variables and performed univariate analysis. A logistic regression model was used to determine the independent risk factors of delayed gastric emptying after pancreaticoduodenectomy, then we refer to the relevant literatures about delayed gastric emptying both insides and overseas to put forward nursing intervention measures. Results: Univariate analysis showed that there were significantly statistical difference in preoperative TB ≥300 umol/L, preoperative ALB < 30g/L, BMI < 18.5k/m2, reoperation, pancreatic fistula, biliary fistula, abdominal/gastrointestinal bleeding, intra-abdominal infection, Postoperative blood glucose ≥11 mmol/L, Postoperative ALB <30g/L, Postoperative Hb < 90 g/L. Multivariate analysis by logistic regression showed that there were significantly statistical difference in BMI<18.5 kg/m2, preoperative TB ≥ 300 umol/L, biliary fistula, pancreatic fistula, postoperative blood glucose ≥ 11mmol/L, postoperative ALB < 30 g/L. Conclusion: The control of malnutrition and hyperglycemia during perioperative period of pancreaticoduodenectomy and the prevention of biliary fistula, pancreatic fistula and abdominal infection after operation are the key to prevent the occurrence of DGE.

参考文献/References:


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备注/Memo

备注/Memo:
作者简介 ：薛 萍，护师，护理硕士研究生，从事护理工作。E-mail：free_999@qq.com 通讯作者 ：方进博，E-mail：1145619397@qq.com
更新日期/Last Update: 1900-01-01