老年患者胃切除术后感染并发症的危险因素
Michihisa Iida1, Shigeru Takeda1, Tsunenori Yamamoto1
1Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.
老年胃癌患者在手术后面临传染性并发症. 男性性别,低营养指数和高内脏脂肪是手术前的主要风险,较长的手术增加了危险.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 手术感染 手术感染
背景情况:
- 胃癌在老年人中是一个重要的健康问题.
- 手术后的传染性并发症对患者的康复和结果构成重大威胁.
- 识别风险因素对于改善老年胃癌患者的手术护理至关重要.
研究的目的:
- 在接受胃切除术的老年胃癌患者中确定感染并发症的术前和术后风险因素.
- 根据确定的手术前风险因素的数量来分层风险.
主要方法:
- 对504名65岁以上的胃癌患者进行了回顾性研究,这些患者接受了激进胃切除术.
- 接收器运行特征 (ROC) 曲线分析,以确定周围操作因子的截止值.
- 后勤回归分析以确定感染并发症的独立风险因素.
- 克拉维恩 - 丁多分类用于分级传染性并发症.
主要成果:
- 18.8%的患者发生了传染性并发症 (II-V级).
- 独立的手术前风险因素包括男性性别,低预后营养指数 (PNI),高内脏脂肪区域和全胃切除术.
- 较低的PNI和长时间的手术时间被确定为独立的外科手术期间风险因素.
- 随着手术前风险因素的增加,感染性并发症的发生率显著增加 (从0个因素的6.7%增加到4个因素的47.6%).
结论:
- 老年胃癌患者有多种手术前风险因素需要在胃切除术前仔细考虑.
- 尽量减少手术时间可能有助于减少这种脆弱人群中感染并发症的发生率.
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