| Objective:Gastric cancer is one of the most common malignant tumor,and its early diagnosis rate is low, low resection rate and case fatality rate ishigh, the current operation is still the primary treatment of gastric cancer.But alot of patients were accompanied by a variety of concomitant, the occurrenceof postoperative complications and gastric cancer patients with preoperativedisease has a very close relationship.Through retrospective analysis ofpreoperative concomitant, actively dealing with preoperative associated withdisease, and thus better able to help clinicians to further reduce the occurrenceof postoperative complications, provide the basis for better treatment ofpatients.Methods:Collect clinical data from1963to2012in the fourth hospital ofhebei medical university11727cases diagnosed as Gastric cancer have beendone surgical treatment, gastric cancer with concomitant disease wereretrospectively analyzed (such as preoperative hemoglobin, preoperativealbumin, blood pressure, etc.) analy the effect of postoperative (intestinalobstruction, bleeding, etc.). Gastric cancer surgery patients clinicalinformation database are set up by using the EXCEL，apply SPSS17.0program to statistical analysis of data, P <0.05that there are significantdifferences.Results:general information：between1963and2012, make a diagnosis and givetreatment for gastric cancer (pathology confirmed) and surgical treatment in11727cases of patients, including a total of9091patients with male, theproportion of77.52%. A total of2636patients with women, the proportion of22.48%. Male: female ratio of3.45:1. Age,21-90years, mean age was55.50±10.79years old.6934cases (59.13%) patients have at least one concomitant disease. Without concomitant disease patients are4793cases(40.87.%).1The relationship of gastric cancer concomitant disease andpostoperative intestinal obstructionTake gastric cancer with high blood pressure and postoperative ileuschi-square test, the difference is statistically significant (chi-square=5.629, P=0.018). Take gastric cancer with heart disease and postoperative intestinalobstruction with chi-square test, the difference is statistically significant(chi-square=4.443, P=0.035). Take gastric cancer with cardiac or pyloricobstruction and postoperative ileus with chi-square test, difference isstatistically significant (chi-square=2.907, P=0.008). Take gastric cancerwith diabetes and postoperative ileus with chi-square test, there is nostatistically significant difference (chi-square=2.674, P=0.102). Takegastric cancer with chronic lung diseases and Postoperative ileus withchi-square test, there is no statistically significant difference (chi-square=1.590, P=0.207). Take gastric cancer with abdominal surgery andpostoperative ileus with chi-square test, there is no statistically significantdifference (chi-square=0.042, P=0.837). Take gastric cancer withhypoalbuminemia and postoperative ileus with chi-square test, there is nostatistically significant difference (chi-square=2.825, P=0.093).2The relationship of gastric cancer concomitant disease andpostoperative bleedingTake gastric cancer with high blood pressure and postoperative bleedingwith chi-square test, difference is statistically significant (chi-square=414.743,P=0.000). Take gastric cancer with heart disease and postoperative bleedingwith chi-square test, the difference is statistically significant (chi-square=5.597, P=0.018). Take gastric cancer with cardiac or pyloric obstruction andpostoperative bleeding with chi-square test, difference is statistically signifi-cant (chi-square=120.795, P=0.000). Take gastric cancer with diabetes andpostoperative hemorr-hage with diabetes with chi-square test, there is nostatistically significant difference (chi-square=2.512, P=0.113). Take gastric cancer with chronic lung diseases and postoperative hemorrhage withchi-square test, there is no statistically significant difference (chi-square=0.235, P=0.625). Take gastric cancer with abdominal surgery andpostoperative bleeding with chi-square test, there is no statistically significantdifference (chi-square=0.067, P=0.796). Take gastric cancer withhypoalbuminemia postoperative hemorrhage with chi-square test, there is nostatistically significant difference (chi-square=0.011, P=0.916).3The relationship of gastric cancer concomitant disease and ascitesTake gastric cancer with high blood pressure and ascites with chi-squaretest, difference is statistically significant (chi-square=8.096, P=0.004). Takegastric cancer with diabetes and ascites with chi-square test, difference isstatistically significant (chi-square=18.932, P=0.000). Take gastric cancer withheart disease and ascites with chi-square test, difference is statisticallysignificant (chi-square=18.769, P=0.000). Take history of gastric cancer withabdominal surgery and ascites with chi-square test, difference is statisticallysignificant (chi-square=12.178,P=0.000). Take the gastric cancer withhypoalbuminemia and ascites with chi-square test, difference is statisticallysignificant (chi-square=221.454, P=0.000). Take gastric cancer with cardiac orpyloric obstruction and ascites with chi-square test, difference is statisticallysignificant (chi-square=333.386, P=0.000). Take gastric cancer with chroniclung diseases and ascites with chi-square test, there is no statisticallysignificant difference (chi-square=0.564, P=0.454).4The relationship of the gastric cancer concomitant disease andpostoperative chest infection diseaseTake gastric cancer with high blood pressure and postoperative chestinfection with chi-square test, there is no statistically significant difference(chi-square=0.964, P=0.326). Take gastric cancer with abdominal surgery andpostoperative chest infection with chi-square test, there is no statisticallysignificant difference (chi-square=0.162, P=0.687). Take gastric cancer withcardiac or pyloric obstruction and the chest infection with chi-square test,there is no statistically significant difference (chi-square=0.024, P=0.887). Take gastric cancer with diabetes and postoperative chest infection withchi-square test, the difference is statistically significant (chi-square=145.023,P=0.000). Take gastric cancer with heart disease and postoperative chestinfection with chi-square test, the difference is no statistically significant(chi-square=0.342, P=0.569). Take gastric cancer with chronic lung diseasesand postoperative chest infection with chi-square test, difference is statisticallysignificant (chi-square=189.233, P=0.000). Take gastric cancer withhypoalbum-inemia and postoperative chest infection with chi-square test, thedifference is statistically significant (chi-square=31.513, P=0.000).5The relationship of gastric cancer concomitant disease andpostoperative pleural effusionTake gastric cancer with high blood pressure and postoperative pleuraleffusion with chi-square test, there is no statistically significant difference(chi-square=7.645, P=0.667. Take gastric cancer with diabetes andpostoperative pleural effusion with chi-square test, there is no statisticallysignificant difference (chi-square=0.417, P=0.516). Take gastric cancer withheart disease and postoperative pleural effusion with chi-square test, there isno statistically significant difference (chi-square=0.324, P=0.596). Takegastric cancer with chronic lung diseases and postoperative pleural effusionwith chi-square test, there is no statistically significant difference (chi-square=2.994, P=0.084). Take gastric cancer with cardiac or pyloric obstruction andpostoperative pleural effusion with chi-square test, there is no statisticallysignificant difference (chi-square=6.223, P=0.013). Take gastric cancer withabdominal surgery and postoperative pleural effusion with chi-square test,there is no statistically significant difference (chi-square=0.001, P=0.971).Take gastric cancer with hypoalbuminemia and postoperative pleuraleffusion with chi-square test, there is no statistically significant difference(chi-square=2.811, P=0.094).6The relationship of gastric cancer concomitant and postoper-ativedigestive tract fistulaTake gastric cancer with high blood pressure and postoperative digestive tract fistula with chi-square test, there is no statistically significant difference(chi-square=2.279, P=0.094). Take gastric cancer with diabetes andpostoperative digestive tract fistula with chi-square test, there is no statisticallysignificant difference (chi-square=1.169, P=0.280). Take gastric cancer withheart disease and postoperative digestive tract fistula with chi-square test,there is no statistically significant difference (chi-square=1.280, P=0.721).Take gastric cancer with chronic lung diseases and postoperative digestivetract fistula with chi-square test, there is no statistically significant difference(chi-square=0.154, P=0.695). Take gastric cancer with history of abdominalsurgery and postoperative digestive tract fistula with chi-square test, there isno statistically significant difference(chi-square=0.177, P=0.674). Take gastriccancer with hypoalbuminemia and postoperative digestive tract fistula withchi-square test, there is no statistically significant difference (chi-square=3.444, P=0.063). Take gastric cancer with cardiac or pyloric obstruction andpostoperative digestive tract fistula with chi-square test, there is statisticallysignificant difference (chi-square=214.884, P=0.000).7The relationship of gastric cancer concomitant disease andpostoperative incision dehiscence and infectionTake gastric cancer with high blood pressure and postoperative incisiondehiscence and infection with the chi-square test, there is no statisticallysignificant difference (chi-square=0.475, P=0.491). Take gastric cancer withhypoalbuminemia and infection and dehiscence of postoperative incision withchi-square test, there is no statistically significant difference (chi-square=3.060, P=0.080) Take gastric cancer with diabetes and postoperative incisiondehiscence and infection with chi-square test, the difference is statisticallysignificant (chi-square=5.711, P=0.017). Take gastric cancer with heartdisease and infection and dehiscence of postoperative incision with chi-squaretest, the difference is statistically significant (chi-square=10.783, P=0.001).Take gastric cancer with chronic obstructive pulmonary disease and infectionand dehiscence of postoperative incision with chi-square test, the difference isstatistically significant(chi-square=10.499, P=0.001). Take history of gastric cancer with abdominal surgery and postoperative incision dehiscence andinfection with chi-square test, the difference is statistically significant(chi-square=17.509, P=0.800). Take gastric cancer with cardiac and pyloricobstruction and postoperative incision dehiscence or infection with chi-squaretest, the difference is statistically significant (chi-square=4.406, P=0.036).8Kidney disease, rheumatoid disease, leukemia and postoperativeintestinal obstruction, bleeding, ascites, pleural effusion, the digestive tractfistula, the chest infection, infection of incision dehiscence and correlationThe three concomitant diseases are common, as a result of the case datais imperfect, the lack of relevant research information, its influence on patientswith gastric cancer and related factors analysis needs further research.9The relationship of mild anemia, moderate anemia, severe anemia inpatients and ascites, the chest infection, postoperative incision dehiscence,bleeding and infection, pleural effusion, intestinal obstruction, gastrointestinalfistulaTake gastric cancer with mild, moderate, severe anemia and ascites withchi square test, difference is statistically significant (chi-square=29.740, P=0.000). Take gastric cancer with mild, moderate, severe anemia andpostoperative chest infectionchi with chi square test, difference is statisticallysignificant(chi-square=53.248, P=0.000). Take gastric cancer with mild,moderate, severe anemia and incision dehiscence and infection withchi-square test, difference is statistically significant (chi-square=25.210, P=0.000). Take gastric cancer with mild, moderate, severe anemia and pleuraleffusion with chi square test, difference is statistically significant (chi-square=12.579, P=0.002). Take gastric cancer with mild, moderate, severe anemiaand bleeding with chi-square test, difference is statistically significant(chi-square=144.657, P=0.000). Take gastric cancer with mild, moderate,severe anemia and intestinal obstruction with chi-square test, there is nostatistically significant difference (chi-square=2.511, P=0.285). Take gastriccancer with mild, moderate, severe anemia and digestive tract fistula withchi-square test, there is no statistically significant difference (chi-square= 1.636, P=1.441).Conclusion:The occurrence of postoperative complications in patientswith gastric cancer is related to many factors, but the incidence of gastriccancer patients with preoperative play a big impact on the occurrence ofpostoperative complications, The gastric cancer concomitant diseasesretrospectively analyzed is summarized as follows:1In this study, the patients with concomitant disease are6934cases, theincidence was59.13%.2In this study,2017patients with gastric cancer are high blood pressure,the rate is17.20%,604patients with gastric cancer are diabetes, the incidenceis5.15%,889patients with gastric cancer are heart disease, the incidence is7.58%,667cases of patients are chronic lung disease, the incidence is5.69%,and803patients with gastric cancer are history of abdominal surgery, theincidence is6.85%,1523cases of gastric cancer patients arevhypoalbuminemia, the rate is12.99%,943cases of patients are cardiac orpyloric obstruction with gastric cancer, the incidence is8.04%,18patientswith gastric cancer are kidney disease, and gastric cancer patients withrheumatic diseases are6, patients with leukemia with stomach cancer is1case,3668patients with mild anemia with gastric cancer, the incidence is31.28%,1144patients with gastric cancer with moderate anemia, the incidence is9.76%,706patients with gastric cancer with severe anemia, the incidence is6.02%.3In this study, among the concomitant disease of preoperative patientswith gastric cancer, the incidence of mild anemia is as high as31.28%.4In this study, among the postoperative complications of gastric cancer,the incidence of intestinal obstruction is as high as1.65%.5In this study, compare preoperative gastric cancer patients with highblood pressure to without hypertension postoperative bleeding is5.55%and0.24%respectively, it is very differrent, positive and good level of bloodpressure has a great influence on the prevention of postoperative bleeding.6Due to poor nutrition metabolism, compare gastric cancer patients with preoperative hypoalbuminemia and without hypoalbuminemia topostoperative ascites and digestive tract fistual, the incidence are6.42%and0.47%,1.84%and1.25%respectively, to correct hypoalbuminemia isbeneficial to reduce the occurrence of ascites.7Patients with gastric cancer as a result of the existence of carcinoidsyndrome, are often accompanied by endocrine disorder, therefore,preoperative patients accompanied by diabetes or not，postoperative chestinfection, incision dehiscence and the proportion of infection and digestivetract fistula are6.46%and0.93%respectively,1.16%and0.46%,1.82%and0.13%. preoperative actively control the blood sugar can reduce the risk ofpostoperative infection and fistula.8Correction of varying degrees of anemia is beneficial to postoperativecomplications. |
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