腹腔鏡胃癌根治術患者術后肺部感染與影響因素分析

朱根英　　吳辰　　魏云?！　⌒煊罓N

[關鍵詞] 腹腔鏡;胃癌根治術;肺部感染;影響因素

[中圖分類號] R735.2? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）19-0007-03

Analysis on postoperative pulmonary infection and influencing factors in the patients undergoing laparoscopic radical gastrectomy of gastric cancer

ZHU Genying? ?WU Chen? ?WEI Yunhai? ?XU Yongcan

Department of Gastrointestinal Surgery，Huzhou Central Hospital in Zhejiang Province，Affiliated Hospital of Huzhou Normal University， Huzhou? ?313000， China

[Abstract] Objective To explore postoperative lung infection and influencing factors in the patients undergoing laparoscopic radical gastrectomy of gastric cancer. Methods A total of 186 patients who underwent laparoscopic radical gastrectomy of gastric cancer in our hospital from January 2018 to December 2018 were selected as the research subjects.The basic data of all gastric cancer patients were investigated and statistically analyzed. A single factor and multi-factor analysis were also carried out on those data. Results 19 of all patients had lung infections， with the infection incidence rate of 10.2%. Among them， the incidence rate of pulmonary infections in the patients with a history of smoking，gastric tube indwelling time ≥6 days， intraoperative blood loss ≥200 mL， and experience of total gastrectomy were higher than the patients with no past history of smoking， postoperative gastric tube indwelling time <6 days， intraoperative blood loss<200 mL and no experience of total gastrectomy（P<0.05）; a past smoking history，bleeding volume ≥200 mL， and postoperative gastric tube indwelling time≥6 days were all independent risk factors for postoperative lung infections in the patients undergoing gastrectomy of gastric cancer（P<0.05）. Conclusion A past smoking history， intraoperative blood loss ≥200 mL，and postoperative gastric tube indwelling time≥6 days are independent risk factors for lung infections after laparoscopic radical gastrectomy of gastric cancer. A detailed understanding of the patient′s physical condition and targeted guidance before surgery can help avoid or reduce the incidence of postoperative lung infections.

[Key words] Laparoscopy; Radical gastrectomy of lung cancer; Lung infection; Influencing factors

目前，胃癌是臨床中較為常見的惡性腫瘤，根治性手術切除仍是對該類患者進行治愈的唯一手段[1]。與傳統的開腹手術比較，腔鏡手術的安全性及臨床效果均相對較好，并具有微創特征[2]。近年來，隨著手術技術的進步及圍手術期處理的改善，胃癌根治術后患者并發癥發生率明顯降低，但肺部感染仍較為常見，致使患者住院時間延長，醫療費用增加，病情嚴重者呼吸功能衰竭或者死亡，對其生活質量產生嚴重影響[3-4]。因此，通過對肺部感染的危險因素進行有效分析，有助于采取有效預防措施促進患者病情恢復[5]。本研究分析腔鏡胃癌根治術患者的臨床資料，并對其術后發生肺部感染的危險因素進行探討，現報道如下。