CAJ | 학술논문

目的：探讨胃大部切除术后发生胃瘫综合征(PGS)的危险因素。方法回顾性分析在我院行胃大部切除术310例患者的临床资料，以发生PGS作为观察组，未发生PGS作为对照组，对两组患者的自身因素、手术因素、术后因素进行单因素分析及Logistic回归分析。结果310例患者共发生PGS15例(4.84％)。单因素分析与PGS有关因素分别为年龄大、术前幽门梗阻、术后高血糖、围手术期低蛋白血症、恶性疾病、毕Ⅱ式、手术时间长、术中出血量多、不良心理、应用镇痛泵、腹腔感染、术后肠内营养时间晚(P<0．05)。对独立危险因素进行Loigstic回归分析，按OR值的大小前四位依次为：术前幽门梗阻、围手术期低蛋白血症、毕Ⅱ式、不良心理。结论PGS发生是多种因素作用的。结果临床上应妥善处理幽门梗阻，尽量采取毕I式胃肠吻合，缩短手术时间，控制血糖，提高血清白蛋白，加强心理支持来预防和减少PGS发生。
목적：탐토위대부절제술후발생위탄종합정(PGS)적위험인소。방법회고성분석재아원행위대부절제술310례환자적림상자료，이발생PGS작위관찰조，미발생PGS작위대조조，대량조환자적자신인소、수술인소、술후인소진행단인소분석급Logistic회귀분석。결과310례환자공발생PGS15례(4.84％)。단인소분석여PGS유관인소분별위년령대、술전유문경조、술후고혈당、위수술기저단백혈증、악성질병、필Ⅱ식、수술시간장、술중출혈량다、불양심리、응용진통빙、복강감염、술후장내영양시간만(P<0．05)。대독립위험인소진행Loigstic회귀분석，안OR치적대소전사위의차위：술전유문경조、위수술기저단백혈증、필Ⅱ식、불양심리。결론PGS발생시다충인소작용적。결과림상상응타선처리유문경조，진량채취필I식위장문합，축단수술시간，공제혈당，제고혈청백단백，가강심리지지래예방화감소PGS발생。
Objective:To explore the risk factors of postsurgical gastroparalysis syndrome(PGS) after subtotal gastrectomy.Methods:310 cases of subtotal gastrectomy were retrospectively analyzed,the cases of PGS were observational group,and the non-PGS were control group,mono-factor analysis and Logistic regression analysis were performed toward the personal factors,surgical factors and postsurgical factors.Results:15 out of 310 cases were PGS(4.84%),the age, preoperative pyloric obstruction,postoperative hyperglycemia,perioperative hypoproteinemia,Bil roth I gastrectomy,long operation time,the amount of intraoperative bleeding,unhealthy psychology,using patient control analgesia,abdominal infection,postoperatively intestinal nutrition late were associated with the PGS by the mono-factor analysis(p<0.05).the results derived from the logistic regression analysis toward the independent risk factor pointed that the top four factors were arranged in according to the value of OR,preoperative pyloric obstruction,perioperative hypoproteinemia,Bil roth I gastrectomy,unhealthy psychology.Conclusions:the incidence of PGS were derived from many factors,treat pyloric obstruction properly,Bil roth I gastrectomy,shorten the operation time,control glycemia,improve the serum albumin,and strong the psychological support can prevent and reduce PGS.