The Risk Factor Analysis And Treatment Of PGS After The Most Radical Distal Gastric Resection

Objective: PGS refers to the operation after the concurrency with gastric motor function as a poor clinical syndrome, often occurred in the patients after abdominal operation, simple gastrectomy in 10% ~ 25% had gastric emptying delay, 5% ~ 10% of the patients had clinical manifestations in the sense of. Often because of postoperative gastric mechanical obstruction of the outflow tract caused by factors, so it is also called functional gastric paralysis after operation, is a common clinical complication after operation on the stomach. It will lead to malabsorption after surgery, resulting in prolonged recovery time, medical costs increased significantly, adverse psychological effects on patients, cause unnecessary trouble, and may cause other complications, and even endanger the lives of patients. Gastroparesis in clinic is easily diagnosed as mechanical gastric outflow obstruction, if the blind use of operation treatment, prone to exacerbation of the disease and even delay the best treatment time. The purpose of this paper is to collect the clinical data by gastrointestinal surgery in our hospital area underwent radical distal gastrectomy patients, analyze the cause of the risk factors of gastric emptying and summarize the treatment measures, provide a reference for future clinical work.Methods:From 2010 January to 2014 December in Fujian Medical University Hospital Affiliated First Hospital of gastrointestinal area because of gastric cancer underwent radical resection of the distal gastrectomy in patients with clinical data, by retrospective analysis, 21 cases of PGS patients as case group, 389 cases occurred in PGS patients as study group. The application of SPSS 19 software were analyzed by single factor analysis of χ2 is statistically significant, as to whether the occurrence of PGS as the dependent variable, 13 possible risk factors for PGS variable assignment, non conditional Logistic regression model was applied to the elements, study the influence of PGS produced by.Results: This study by univariate test showed that 2 gastrointestinal anastomosis, preoperative pyloric obstruction, preoperative malnutrition, postoperative abdominal complications, postoperative enteral nutrition time had statistical significance(P<0.05); multivariate Logistic regression analysis showed that: Billroth II, preoperative, postoperative pyloric obstruction enteral nutrition time, preoperative malnutrition, abdominal complications after surgery are the risk factors of PGS(OR < 1, P < 0.05).Conclusion: Radical distal gastrectomy is related to multiple factors of PGS resection, Billroth II type, preoperative pyloric obstruction, postoperative enteral nutrition time, preoperative malnutrition, postoperative abdominal complications may be the risk factors of postoperative gastroparesis, abdominal postoperative complications were high risk factors PGS. The disposal of the positive risk factors can reduce the probability of occurrence of PGS. Gastroparesis patients as much as possible by conservative treatment.