中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (08): 687-690.

• 论著 • 上一篇    下一篇

代谢综合征对胃癌术后并发症短期结局影响的多因素分析

周成富1，李世宽2，周岩冰2，周晓斌3   

  1. 1复旦大学医学院，上海200032；2青岛大学医学院附属医院普外科，山东青岛266003；3青岛大学医学院统计学教研室，山东青岛266003
  • 出版日期:2010-08-01 发布日期:2010-08-02

  • Online:2010-08-01 Published:2010-08-02

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摘要：

目的    探讨胃癌术后并发症的影响因素,评价代谢综合征及其相关因素对胃癌术后并发症的影响作用。方法    2006年1月至2008年6月青岛大学医学院附属医院普外科共行开腹手术治疗胃癌639例。统计其并发症发生情况及常见胃癌并发症影响因素。进行单因素及多因素Logistic回归分析。结果    98例发生了不同的术后并发症，总体发生率为15.3%。包括手术时间、术前血红蛋白、术中出血量、体重指数(body mass index, BMI)、入院血糖、术后血糖、术前总胆红素、术前前白蛋白、术后超敏C反应蛋白、联合脏器切除、营养不良、体重减轻＞10%、代谢综合征（metabolic syndrome, MS）、糖尿病（diabetes mellitus, DM）、肥胖、高血压病、术者手术例数、肝硬化、肿瘤出血、TNM分期、年龄、浸润深度等22项因素与本组病人术后并发症的发生有关。其中联合脏器切除、营养不良、MS、肥胖、T4期、DM、手术时间、术中出血量、年龄、术前总胆红素、术者手术例数等11种因素被纳入回归方程。结论    联合脏器切除、营养不良、MS、肥胖、T4、DM、手术时间、术中出血量、年龄、术前总胆红素、医师手术例数等是影响本组胃癌病人术后并发症的主要危险因素；MS对胃癌术后并发症的影响较大，应加以重视。

关键词: 胃癌, 术后并发症, 多因素分析, 代谢综合征

Abstract:

Multivariate analysis of risk factors of postoperative complications in patients with gastric cancer        ZHOU Cheng-fu*, LI Shi-kuan, ZHOU Yan-bing, et al. *Medical School of Fudan University, Shanghai266003, China
Corresponding author: LI Shi-kuan, E-mail: world width@yahoo.com.cn
Abstract    Objective    To investigate the main risk factors of postoperative complications in patients with gastric cancer. Methods    The complication data and common risk factors of 639 gastric cancer patients performed gastrectomy between January 2006 and June 2008 in Department of General Surgery, the Affiliated Hospital of Qingdao University Medical College were analyzed by means of single factor analysis and multivariate logistic regression analysis. Results    A total of 98 patients experienced different post-operative complications (15.3%). Twenty-two factors including duration of operation, preoperative Hb, preoperative prealbumin, blood lose during the operation, BMI, preoperative blood glucose, postoperative blood glucose, preoperative total bilirubin, postoperative C-reaction protein, weight lose over 10%, malnutrition, combined organ resection, T4, obesity, metabolic syndrome (MS), DM, hypertension, hepatic cirrhosis, tumor hemorrhage, surgeon's operative volume , age and tumor invasion were related with post-operative complications. Eleven factors including combined organ resection, malnutrition, MS, obesity, T4, DM, duration of the operation, blood lose, age, preoperative total bilirubin and surgeon's operative volume were analyzed by multivariate Logistic regression analysis. Conclusion Combined organ resection, malnutrition, MS, obesity, T4, DM, duration of the operation, blood lose, age, preoperative total bilirubin and surgeon's operative volume were the main risk factors of postoperative complications in gastric cancer patients. MS is regarded as a great impact on the postoperative complications, and should be paid on more attention.

Key words: stomach neoplasm, postoperative complication, multivariate analysis, metabolic syndrome