胃癌术后胃肠功能障碍的危险因素及芪黄煎剂的作用

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 Qihuang 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 surgery,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 factors 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 Qihuang Decoction were protective factors (P<0.05). Conclusion There is a relatively high incidence rate of early gastrointestinal dysfunction in patients undergoing surgery.The risk factors that can aggravate gastrointestinal dysfunction should be controlled during prevention and treatment,and Qihuang Decoction combined with enteral nutrition should be taken seriously to improve the nutritional status of patients.