Risk Factors Analysis And Evaluation Of Gastroparesis Syndrome After Distal Gastrectomy For Gastric Cancer

Objective:To explore the risk factors of gastroparalysis after radical gastrectomy for distal gastric cancer,and to discuss the pathogenesis of postoperative gastroparalysis syndrome,in order to provide certain reference for clinical work,in order to reduce the incidence of gastroparalysis after radical gastrectomy for distal gastric cancer.Methods: This study collected all 409 patients with gastric cancer who underwent distal radical gastrectomy in the gastrointestinal surgery ward of the first affiliated hospital of wannan medical college from January 2016 to December 2018.According to the occurrence of postoperative gastroparesis,25 of them were classified as case group,and the remaining 384 patients were classified as control group.With the occurrence of postoperative gastroparesis as the dependent variable,28 indicators such as general data,preoperative,intraoperative and postoperative indicators were selected as the independent variables,and a single factor statistical analysis was performed on these indicators to obtain the relevant risk factors with statistical significance.Then,multivariate logistic regression analysis was carried out to obtain independent risk factors and independent protective factors.Results: 1.A total of 409 patients underwent radical resection of distal gastric cancer were included in this study,including 295 males and 114 females,with a male to female ratio of about 3:1.The patients were aged 30-85 years,with an average age of(58.30±15.27)years.Among these patients,there were 25 patients with PGS and 384 patients without PGS,and the incidence of postoperative gastroparesis was 6.11%.2.Univariate analysis results show:A history of high blood pressure,obesity(BMI)of28 kg/m2 or,perioperative hyperglycemia 8 tendency(P/L),has a history of abdominal surgery,preoperative hypoalbuminemia,preoperative prealbumin,preoperative exists pyloric obstruction,preoperative JiaJian,operation duration,the digestive tract reconstruction method(bi I type,bi II type,finish II + Braun type,Roux en-Y type),postoperative analgesia pump,albumin,and albumin before on the first day after operation,postoperative complications occurred such as index of statistical significance(P < 0.05),And age,sex,smoking history,drinking history,preoperative total protein,preoperative hemoglobin,surgical procedure,intraoperative use of nano carbon display lymph nodes,intraoperative blood loss,whether the malignant degree of tumor differentiation,tumor invasion,vascular tumor emboli,whether there is the first day of the total protein and postoperative hemoglobin has no statistical significance(P > 0.05).3.Multiple factor analysis showed: preoperative pyloric obstruction,preoperative hypertension,obesity(BMI)28 kg/m2 OR more,the digestive tract reconstruction methods,postoperative analgesia pump and perioperative hyperglycemia are independent risk factors of PGS(OR > 1,P < 0.05),while operating time < 3 h and preoperative albumin ? 30 g/L for the PGS OR independent protective factors(OR < 1,P < 0.05).Conclusion: The pathogenesis of postoperative gastric paralysis syndrome is complicated,is produced by the combined action of many factors influence each other,including preoperative pyloric obstruction,preoperative hypertension,obesity(BMI)28 kg/m2 or more,the digestive tract reconstruction methods,postoperative analgesia pump and perioperative hyperglycemia these indicators play a key role in the PGS.