上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (4): 407-.doi: 10.3969/j.issn.1674-8115.2019.04.014

• 论著·临床研究 • 上一篇    下一篇

胃肠道肿瘤患者术中联合腹腔热灌注化学治疗对术后胃肠功能恢复的影响因素分析

杨华 1，陈青 1，邓力 1，曹烨 1，李文翔 1，徐静 1, 2，王炯元 1, 2，童汉兴 1, 2，周宇红 3，张勇 1, 2，陆维祺 1, 2   

  1. 1. 上海市（复旦大学附属）公共卫生临床中心 /复旦大学附属中山医院南院普外科，上海 200083；复旦大学附属中山医院普外科，上海 200032；3. 复旦大学附属中山医院肿瘤内科，上海 200032
  • 出版日期:2019-04-28 发布日期:2019-05-23
  • 通讯作者: 陆维祺，电子信箱：lu.weiqi@zs-hospital.sh.cn。
  • 作者简介:杨华（1980—），男，主治医师，博士；电子信箱： huayang@fudan.edu.cn。
  • 基金资助:
    上海市（复旦大学附属）公共卫生临床中心院级课题（KY-GW-2017-12）

Analysis of factors influencing postoperative gastrointestinal function recovery in patients undergoing hyperthermic intraperitoneal chemotherapy

YANG Hua1, CHEN Qing1, DENG Li1, CAO Ye1, LI Wen-xiang1, XU Jing1, 2, WANG Jiong-yuan1, 2, TONG Han-xing1, 2, ZHOU Yu-hong3, ZHANG Yong1, 2, LU Wei-qi1, 2   

  1. 1. Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200083, China; 2. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 3. Department of Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
  • Online:2019-04-28 Published:2019-05-23
  • Supported by:
    Shanghai Public Health Clinical Center Fund, KY-GW-2017-12

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摘要： 目的 ·探讨胃肠道肿瘤患者术中联合腹腔热灌注化学治疗对术后胃肠功能恢复的影响。方法 ·收集 2014年 7月— 2017年 6月在上海市（复旦大学附属）公共卫生临床中心 /复旦大学附属中山医院南院行细胞减灭术联合腹腔热灌注化学治疗的胃肠道肿瘤患者 62例。根据 I-FEED评分系统对患者的胃肠功能评分，将其分为胃肠功能恢复顺利组（ I-FEED评分 < 6分，38例）和延迟恢复组（I-FEED评分 ≥ 6分，24例）。选择包括性别、年龄、是否合并糖尿病、术前白蛋白等可能对 2组患者术后胃肠功能恢复有影响的特征性因素进行单因素分析和多因素 Logistic分析。结果 ·胃肠功能恢复顺利组和延迟组患者在术前白蛋白水平（ P0.040）、术中出血量（P0.044）、腹腔引流管拔除时间（ P0.026）、导尿管拔除时间（ P0.021）和住院时间（ P0.017）的相关指标上的差异均存在统计学意义。多因素 Logistic回归结果提示术前白蛋白水平可能有利于术后胃肠功能顺利恢复 (OR0.84, 95% CI 0.17～ 4.27，P0.041)。结论 ·对于行细胞减灭术联合腹腔热灌注化学治疗的胃肠道肿瘤患者，术前白蛋白可作为术后胃肠功能恢复障碍发生的独立预测因素。

关键词: 胃肠道肿瘤, 细胞减灭术, 腹腔热灌注化学治疗, 胃肠功能恢复

Abstract:

Objective · To investigate the effect of hyperthermic intraperitoneal chemotherapy on postoperative gastrointestinal function recovery in patients with gastrointestinal cancer. Methods · Sixty-two cases of gastrointestinal cancer patients were enrolled who accepted cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, July 2014 to June 2017. The gastrointestinal function of patients were evaluated according to the I-FEED scoring system. The patients were divided into normal recovery group (I-FEED score<6, n38) and delayed recovery group (I-FEED score ≥6, n24). Univariate and multivariate Logistic analyses were performed on characteristic factors that may affect the recovery of postoperative gastrointestinal function including gender, age, presence of diabetes, preoperative albumin, and so on. Results · There were significantly differences in the preoperative serum albumin level (P0.040), intraoperative bleeding (P0.044), the time of extraction of the peritoneal cavity drainage tube (P0.026), the time of urethral tube extraction (P0.021) and the time of hospitalization (P0.017) in the two groups of patients with normal or delayed gastrointestinal function recovery. Multivariate Logistic regression results suggested that preoperative serum albumin level may be beneficial for the recovery of postoperative gastrointestinal function (OR0.84, 95% CI 0.17-4.27, P0.041). Conclusion · The preoperative serum albumin level can be used as an independent predictor of postoperative gastrointestinal functional recovery in patients with gastrointestinal cancer after cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. [Key words]gastrointestinal tumor; cytoreductive surgery; hyperthermic intraperitoneal chemotherapy; gastrointestinal function recovery

Key words: gastrointestinal tumor, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, gastrointestinal function recovery

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