CAJ | 학술논문

目的：回顾性分析胃癌D2/D3根治术隐匿性休克的发生率及术后并发症率。方法共选取我院2009年3月至2013年6月胃癌D2/D3根治术老年患者126例，根据动脉血乳酸及收缩压将病例分成三组，即隐匿性休克组、显性休克组、无休克组。隐匿性休克患者占23．8％（30/126），显性休克患者占7．1％（9/126），无休克患者占69．1％（87/126）。比较三组术后并发症的差异性。结果术后7 d并发症，隐匿性休克组为16．7％（95％ CI 10～31），显性休克组为22．2％（95％ CI 11～36），无休克组为1．1％（95％ CI 1～3）。隐匿性休克组和显性休克组术后并发症发生率相当，差异无统计学意义（P ＝0．953）。结论胃癌D2/D3根治术术中隐匿性休克发生率高，术后并发症发生率与显性休克相当，应引起临床医护人员的重视，及早识别并治疗。
목적：회고성분석위암D2/D3근치술은닉성휴극적발생솔급술후병발증솔。방법공선취아원2009년3월지2013년6월위암D2/D3근치술노년환자126례，근거동맥혈유산급수축압장병례분성삼조，즉은닉성휴극조、현성휴극조、무휴극조。은닉성휴극환자점23．8％（30/126），현성휴극환자점7．1％（9/126），무휴극환자점69．1％（87/126）。비교삼조술후병발증적차이성。결과술후7 d병발증，은닉성휴극조위16．7％（95％ CI 10～31），현성휴극조위22．2％（95％ CI 11～36），무휴극조위1．1％（95％ CI 1～3）。은닉성휴극조화현성휴극조술후병발증발생솔상당，차이무통계학의의（P ＝0．953）。결론위암D2/D3근치술술중은닉성휴극발생솔고，술후병발증발생솔여현성휴극상당，응인기림상의호인원적중시，급조식별병치료。
Objective To analyze the incidence of cryptic shock and postoperative complications after D2/D3 radical resection for gastric carcinoma retrospectively.Methods From March 2009 to June 2013,126 elderly patients with D2/D3 radical resection for gastric carcinoma were enrolled.According to the levels of arterial blood lactate and systolic blood pressure,the patients were divided into three groups, including 23.8%(30/126)of cryptic shock,7.1%(9/126)of overt shock and 69.1%(87/126)with no shock.Differences in postoperative complications were compared among groups.Results At the 7th day after operation,the rates of complications were 16.7%(95% CI 10~31)in the cryptic shock group,22. 2%(95% CI 11 ~36)in the overt shock group and 1.1%(95% CI 1 ~3)in the no shock group.There was no difference in complications between the cryptic shock group and overt shock group(P=0.953). Conclusion During the D2/D3 radical resection for gastric carcinoma,the incidence of cryptic shock is high and it carries a similar complication rate as the overt shock.It should cause the attention of clinical staffs and require early identification and management.