分析老年胃癌患者腹腔镜根治术后肠麻痹的影响因素。

回顾性分析2018年1月至2019年7月两家医院收治的老年胃癌患者312例资料，所有患者均行腹腔镜根治术，依据肠麻痹诊断标准将患者分为肠麻痹组(128例)与非肠麻痹组(184例)，数据采用SPSS20.0统计软件处理，两组患者术后肠麻痹的单因素分析采用χ²检验，对具有统计意义的单因素分析结果行多因素logistic回归分析，计算OR和95%可信区间。以P<0.05为差异有统计学意义。

本组128例老年胃癌患者术后发生肠麻痹，占41.03%；184例术后未发生肠麻痹，占58.97%。单因素分析显示，肠麻痹组患者在年龄、术后体温、使用阿片类药物、TNM分期、手术持续时间、胃切除方式等方面与非肠麻痹组相比，差异有统计学意义(P<0.05)。多因素分析结果显示，年龄≥65岁、术后体温≥38℃、使用阿片类药物、TNM分期≥Ⅲ期、手术持续时间≥4 h、胃部全切除是导致老年胃癌患者腹腔镜术后发生肠麻痹的危险因素(OR>1，P<0.05)。

年龄≥65岁、术后体温、使用阿片类药物、TNM分期≥Ⅲ期、手术持续时间≥4h、胃部全切除是导致老年胃癌患者腹腔镜术后发生肠麻痹的危险因素，临床应做好预防措施，避免肠麻痹发生，改善患者预后效果。

To analyze the influencing factors of postoperative enteroplegia in senile patients with gastric cancer after laparoscopic surgery.

The data of 312 senile patients with gastric cancer, admitted to the two hospitals from January 2018 to July 2019, were analyzed retrospectively. All the patients underwent radical laparoscopic surgery, According to the diagnostic criteria of intestinal paralysis, the patients were divided into the intestinal paralysis group (128 cases) and the non-intestinal paralysis group (184 cases). Statistical analysis were performed by using SPSS20.0 software. Univariate analysis of postoperative enteroplegia in the two groups were performed by using χ² test. Multivariate logistic regression analysis were performed for the statistically significant univariate analysis results, while OR and 95% confidence interval were calculated. A P value of <0.05 was considered as statistically significant difference.

Postoperative enteroplegia occurred in 128 elderly patients (41.03%) with gastric cancer. No intestinal paralysis occurred in 184 cases (58.97%). Compared with the non-enteroplegia group, there were statistically significant differences in terms of age, postoperative body temperature, use of opioids, TNM staging, operative time and procedures (P<0.05). Multi-factor analysis showed that the age of ≥ 65, postoperative body temperature of ≥38 ℃, use of opioids, TNM staging of ≥Ⅲ, operative time of ≥ 4 h, total gastrectomy were risk factors of postoperative enteroplegia of elderly patients with gastric cancer after laparoscopic surgery (OR>1, P<0.05).

Age of ≥ 65 years old, postoperative temperature, use of opioids, TNM staging of ≥ Ⅲ, duration of surgery of ≥4h, total gastrectomy are risk factors for enteroplegia after laparoscopic radical resection in senile gastric cancer patients. The preventive measures should be taken in clinical practice to avoid enteroplegia and improve the prognosis of patients.