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胃癌术后胃肠功能障碍的危险因素及芪黄煎剂的作用

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目的 探讨胃癌术后胃肠功能障碍的危险因素及芪黄煎剂的作用.方法 收集 83 例胃癌 D2 根治术患者的临床资料,按术后有无急性胃肠功能障碍(acute gastrointestinal injury,AGI)将患者分为有AGI组 32 例,无AGI组 51 例,对两组患者临床资料进行单因素分析,将P<0.05 独立因素纳入二项分类 Logistics回归,分析影响术后胃肠功能的相关因素.结果 与无 AGI组比较,有 AGI组术前白蛋白、肿瘤大小、肿瘤 pTNM(病理)分期、肿瘤cTNM(临床)分期、手术方式、术中出血量、芪黄煎剂治疗是影响术后胃肠运动的独立影响因素(P<0.05).多因素回归分析显示,肿瘤大小、手术方式及术中出血量是危险因素(P<0.05),而术前白蛋白和芪黄煎剂治疗为保护因素(P<0.05).结论 手术后患者早期胃肠功能障碍发生率较高,在防治中应重点控制可加重胃肠功能障碍的危险因素,并重视芪黄煎剂联合肠内营养改善患者营养状况.
Risk Factors for Gastrointestinal Dysfunction After Gastric Cancer Surgery and the Role of Qi-huang Decoction
Objective To investigate the risk factors for gastrointestinal dysfunction after gastric cancer surgery and the role of Qihuang Decoction.Methods Clinical data were collected from 83 patients with gastric cancer who underwent D2 radical sur-gery,and according to the presence or absence of gastrointestinal dysfunction after surgery,they were divided into dysfunction group with 32 patients and non-dysfunction group with 51 patients.A univariate analysis was performed for the clinical data,and the independent factors with P<0.05 were included in the binary logistic regression analysis to investigate the influencing fac-tors for gastrointestinal function after surgery.Results Compared with the non-dysfunction group,the dysfunction group had the independent influencing factors for postoperative gastrointestinal motility:preoperative albumin,tumor size,tumor pTNM pathological stage,tumor cTNM clinical stage,surgical procedure,intraoperative blood loss,and treatment with the traditional Chinese medicine(TCM)Qihuang Decoction(P<0.05).The multivariate regression analysis showed that tumor size,surgical procedure,and intraoperative blood loss were risk factors(P<0.05),while preoperative albumin and TCM treatment with Qi-huang Decoction were protective factors(P<0.05).Conclusion There is a relatively high incidence rate of early gastrointesti-nal dysfunction in patients undergoing surgery.The risk factors that can aggravate gastrointestinal dysfunction should be con-trolled during prevention and treatment,and Qihuang Decoction combined with enteral nutrition should be taken seriously to im-prove the nutritional status of patients.

Gastrointestinal dysfunction Qihuang DecoctionSurgeryInfluencing factors

牛晓勇、于庆生、郑州

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安徽中医药大学第一临床医学院,安徽 合肥 230031

安徽中医药大学第一附属医院,安徽 合肥 230031

安徽省中医药科学院中医外科研究所,安徽 合肥 230031

胃肠功能障碍 芪黄煎剂 手术 影响因素

国家自然科学基金国家临床重点专科建设项目(十二五)

82174160财社[2013]239号

2024

安徽中医药大学学报
安徽中医学院

安徽中医药大学学报

CSTPCD
影响因子:0.796
ISSN:2095-7246
年,卷(期):2024.43(2)
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