胃癌术后症状性胸腔积液多因素Logistic分析
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摘要
目的分析胃癌术后症状性胸腔积液的病因。方法对312例胃癌术后患者手术方式及临床指标行单因素分析,取有意义的指标行多因素Logistic回归分析。结果是否行腹腔镜手术、手术时间、术后血清白蛋白水平、术中液体输入量、术中失血量与胃癌根治术后并发症状性胸腔积液相关。行Logistic回归分析显示,手术时间>4 h、腹腔镜手术及术后血清白蛋白>30 g/L与术后症状性胸腔积液相关。结论手术时间>4 h为胃癌术后并发症状性胸腔积液独立危险因素,腹腔镜手术及术后血清白蛋白>30 g/L为保护性因素。
Objective To analyze the risk factors of symptomatic pleural effusion after radical gastrectomy. Methods single factor analysis was used in clinical variables of 312 patients who underwent radical gastrectomy.and then,multivariate logistic regression analysis was used in the selected variables.Results Five clinical variables,inculding laparoscopic surgery, the operation time, postoperative serum albumin level, intraoperative fluid input, intraoperative blood loss,were selected throught single factor analysis.By multivariate logistic regression analysis it was revealed that there were three significant factors which included laparoscopic surgery, the operation time, postoperative serum albumin level.Conclusion The operationtime over 4h is an independent risk factor for symptomatic pleural effusion. Laparoscopic surgery and serum albumin over 40g/L are protective factors for symptomatic pleural effusion.
Objective To analyze the risk factors of symptomatic pleural effusion after radical gastrectomy. Methods single factor analysis was used in clinical variables of 312 patients who underwent radical gastrectomy.and then,multivariate logistic regression analysis was used in the selected variables.Results Five clinical variables,inculding laparoscopic surgery, the operation time, postoperative serum albumin level, intraoperative fluid input, intraoperative blood loss,were selected throught single factor analysis.By multivariate logistic regression analysis it was revealed that there were three significant factors which included laparoscopic surgery, the operation time, postoperative serum albumin level.Conclusion The operationtime over 4h is an independent risk factor for symptomatic pleural effusion. Laparoscopic surgery and serum albumin over 40g/L are protective factors for symptomatic pleural effusion.
引文
[1] Chen W,Sun K,Zheng R,et al.Cancer incidence and mortality in China,2014[J].Chin J Cancer Res,2018,30(1):1-12.
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[3] Porcel JM,Light RM.Diagnostic approach to pleural effusion in adults[J].Am Fam Physician,2006,73(7):1211-1220.
[4] Ntutumu R,Liu H,Zhen L,et al.Risk factors for pulmonary complications following laparoscopic gastrectomy:A single-center study[J].Medicine,2016,95(32):4567.
[5] 兰飞,谭晓俊.胃癌根治术后并发症的相关因素分析[J].中国现代医学杂志,2015,25(2):99-102.
[6] 刘晓欧,干诚,黄光伟.麻醉与患者手术后医院感染的相关因素分析[J].中华医院感染学杂志,2013,23(20):4922-4923.
[7] 陈秀秀,黄宝俊,徐亮.常见腹部手术后并发胸腔积液的临床分析[J].国际外科学杂志,2016,43(11):782-785.
[8] 中华医学会外科分会腹腔镜与内镜外科学组.腹腔镜胃癌手术操作指南(2007年版)[J].中华消化外科杂志,2007,6(6):476-480.
[9] Chen K,Xu XW,Zhang RC,et al.Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer[J].World Journal of Gastroenterology,2013,19(32):5365-5376.
[10] 李东.老年胃癌术后肺部并发症危险因素分析[J/CD].中华普外科手术学杂志(电子版),2014(2):151-153.
[11] 郑成,陈平,戴文宇,等.胃癌术后早期症状性胸腔积液的相关因素分析[J].中华普通外科杂志,2016,31(5):432-433.
[2] Yang L,Zheng R,Wang N,et al.Incidence and mortality of stomach cancer in China,2014[J].Chin J Cancer Res,2018,30(3):291-298.
[3] Porcel JM,Light RM.Diagnostic approach to pleural effusion in adults[J].Am Fam Physician,2006,73(7):1211-1220.
[4] Ntutumu R,Liu H,Zhen L,et al.Risk factors for pulmonary complications following laparoscopic gastrectomy:A single-center study[J].Medicine,2016,95(32):4567.
[5] 兰飞,谭晓俊.胃癌根治术后并发症的相关因素分析[J].中国现代医学杂志,2015,25(2):99-102.
[6] 刘晓欧,干诚,黄光伟.麻醉与患者手术后医院感染的相关因素分析[J].中华医院感染学杂志,2013,23(20):4922-4923.
[7] 陈秀秀,黄宝俊,徐亮.常见腹部手术后并发胸腔积液的临床分析[J].国际外科学杂志,2016,43(11):782-785.
[8] 中华医学会外科分会腹腔镜与内镜外科学组.腹腔镜胃癌手术操作指南(2007年版)[J].中华消化外科杂志,2007,6(6):476-480.
[9] Chen K,Xu XW,Zhang RC,et al.Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer[J].World Journal of Gastroenterology,2013,19(32):5365-5376.
[10] 李东.老年胃癌术后肺部并发症危险因素分析[J/CD].中华普外科手术学杂志(电子版),2014(2):151-153.
[11] 郑成,陈平,戴文宇,等.胃癌术后早期症状性胸腔积液的相关因素分析[J].中华普通外科杂志,2016,31(5):432-433.