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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。
Objective To investigate the influencing factors of postoperative complications of gastric cancer and evaluate the effect of metabolic syndrome and its related factors on the postoperative complications of gastric cancer. Methods From January 2006 to June 2008, 639 cases of gastric cancer were treated by laparotomy in Department of General Surgery, Affiliated Hospital of Medical College of Qingdao University. Statistics complication and common gastric cancer complications factors. Univariate and multivariate logistic regression analysis. Results 98 cases of different postoperative complications occurred, the overall incidence was 15.3%. Including operation time, preoperative hemoglobin, intraoperative blood loss, body mass index (BMI), admission blood glucose, postoperative blood glucose, preoperative total bilirubin, preoperative prealbumin, postoperative hypersensitive C-reactive protein , Joint organ removal, malnutrition, weight loss> 10%, metabolic syndrome (MS), diabetes mellitus (DM), obesity, hypertension, number of surgical operations, cirrhosis, , TNM stage, age, depth of invasion and other 22 factors associated with the occurrence of postoperative complications in this group of patients. Eleven factors such as combined organ removal, malnutrition, MS, obesity, T4, DM, operation time, intraoperative blood loss, age, preoperative total bilirubin and the number of surgical patients were included in the regression equation. Conclusion Combined organ resection, malnutrition, MS, obesity, T4, DM, operation time, intraoperative blood loss, age, preoperative total bilirubin, the number of cases of physician surgery is the impact of this group of patients with gastric cancer postoperative complications The main risk factors; MS on the postoperative complications of gastric cancer greater impact should be given.