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[目的]探讨食管癌患者术后胃瘫综合征发病相关因素及预防对策。[方法]食管癌术后发生胃瘫综合征40例作为观察组,按1∶1比例选择40例食管癌术后未发生胃瘫综合征患者作为对照组,比较两组患者各项指标的差异。[结果]单因素分析显示年龄、体质指数、白蛋白水平、焦虑评分、血糖水平、手术方式、手术操作(胃游离不充分,吻合时张力过大、膈胃固定过松或缝线脱落等)、术中失血量、手术时间、镇痛泵使用情况与胃瘫综合征的发生有关(P<0.05),而性别、切口长度、平均日补液量与胃瘫综合征的发生无关(P>0.05)。Logistic回归法分析结果显示胃瘫综合征的独立影响因素:焦虑评分≥14(OR=4.09,95%CI:1.22~23.27)、手术不当(OR=3.77,95%CI:1.41~24.94)、手术时间长(OR=3.35,95%CI:1.02~18.34)、白蛋白水平低(OR=2.96,95%CI:1.11~17.30)。[结论]食管癌术后胃瘫综合征影响因素复杂,应实施心理支持、合理手术、缩短手术时间、营养支持以减少胃瘫综合征的发生。
[Objective] To explore the related factors of postoperative gastroparesis syndrome in esophageal cancer patients and the preventive measures. [Method] Forty cases with gastroparesis syndrome after esophageal cancer operation were selected as the observation group. 40 patients with gastroparesis syndrome were selected as the control group according to the ratio of 1: 1, and the difference of each index between the two groups was compared . [Results] Univariate analysis showed that age, body mass index, albumin level, anxiety score, blood sugar level, operation mode, operation procedure (insufficient gastric emptying, excessive tension during anastomosis, loose fixation of the diaphragm and stomach, (P <0.05), but no correlation was found between gender, incision length and average daily rehydration volume and the occurrence of gastroparesis syndrome (P> 0.05), and the blood loss, operation time and the usage of analgesia pump were related to the occurrence of gastroparesis syndrome ). Logistic regression analysis showed that the independent influencing factors of gastroparesis syndrome were anxiety score≥14 (OR = 4.09, 95% CI: 1.22-23.27), improper operation (OR = 3.77,95% CI: 1.41-24.94) (OR = 3.35, 95% CI: 1.02-18.34), low albumin level (OR = 2.96, 95% CI: 1.11-17.30). [Conclusion] The influencing factors of postoperative gastroparesis syndrome complicated by esophageal cancer should be implemented psychological support, reasonable surgery, shorten the operation time and nutritional support to reduce the occurrence of gastroparesis syndrome.