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目的探讨引起食管-贲门癌术后胃瘫综合征的相关因素及预防对策。方法选择2005年1月-2010年7月食管-贲门癌术后胃瘫综合征41例作为观察组,按照1∶2比例选择82例同期食管-贲门癌术后非胃瘫综合征患者作为对照组,比较两组患者在围手术期因素上的差异,进行单因素t及χ2检验,然后将单因素分析得出的显著性变量进行多因素Logistic统计分析。结果单因素检验年龄大、女性、精神-神经因素、伴发疾病、急诊手术、手术时间长、术中出血量多;补液量多、术后开始行肠内营养的时间早、不良的进食过程等10个变量是胃瘫综合征的因素(P<0.05),采用Logistic回归分析手术时间长、不良的进食过程、伴发疾病、存在精神-神经因素是独立危险因素。结论胃瘫综合征发生率较高,与多种因素有关,需要尽量缩短手术时间;术后保持有效胃肠减压,合理饮食;积极处理存在伴发疾病;提供多种心理支持相应预防对策减少或者避免胃瘫综合征的发生。
Objective To investigate the related factors of postoperative gastroparesis syndrome caused by esophageal and gastric cardia cancer and the preventive measures. Methods From January 2005 to July 2010,41 cases of postoperative gastroesophageal syndrome of esophageal and gastric cardia were selected as the observation group. According to the ratio of 1: 82, 82 cases of non-gastroparesis syndrome after esophageal-gastric cardia resection were selected as control Group. The differences in perioperative factors between the two groups were compared. Univariate t and χ2 tests were performed. Then the multivariate Logistic statistical analysis was made on the significant variables obtained by univariate analysis. Results Univariate test showed that age, females, psycho-neurological factors, concomitant diseases, emergency surgery, long operation time and more intraoperative blood loss were found. (P <0.05). Logistic regression analysis was used to analyze the long-term operation, poor eating process, concomitant diseases, and the presence of neuro-neurological factors as independent risk factors. Conclusions The incidence of gastroparesis syndrome is high, which is related to many factors and needs to shorten the operation time as much as possible. After the operation, maintain the effective gastrointestinal decompression and reasonable diet; actively deal with the presence of concomitant diseases; provide various psychological support and reduce the corresponding preventive measures Or to avoid the occurrence of gastroparesis syndrome.