【作者】 姚硕；

【导师】 李林虎；

【作者基本信息】 延边大学 ， 外科学， 2011， 硕士

【摘要】 目的分析影响胃癌术后并发症的危险因素,寻求产生胃癌术后并发症的主要原因。方法回顾性分析,自2005年1月至2009年12月延边大学附属医院手术治疗的胃癌患者共289例,对其术前状况进行评估,其中包括：年龄、术前血红蛋白水平、术前白蛋白水平、乙型肝炎、术前肝功能、心功能、肺功能、高血压、糖尿病、肿瘤的部位、直径、浸润程度、Borrmann分型、淋巴结转移范围、手术方式、术中失血量、术中和术后是否输血、手术时间的长短等18项可能引起患者术后出现并发症的临床资料及影响胃癌术后出现并发症的各种因素进行单因素分析进行统计学分析.结果所有患者中合并有并发症的患者46例。并发症按其出现率由高至低依次为切口感染、肺部感染或积液、‘腹腔感染、肠梗阻、吻合口瘘。患者术后并发症的出现与下列因素有关：1、患者本身的因素包括：年龄、术前伴发病包括：贫血、心脏病、呼吸系统疾病、高血压、糖尿病；以及白蛋白水平。2、手术的因素：手术方式、淋巴结清扫范围、手术时间、术中出血量等；3、病变本身的因素：肿瘤的大小、肿瘤分期、Borrmann分型等。结论1、患者术后并发症的出现是由多种原因综合引起的其中包括患者术前各种伴发病、病变本身因素以及手术方式的选择有关。而没有单一的绝对因素决定术后并发症的出现。2、合理的术前准备和术式的选择是减少术后并发症的关键。D2清扫较D1清扫术后并发症的发生率增高。更多还原

【Abstract】 Objective:To analysis the risk factors of complication of gastric cancer, and make a statistical analysis. To find out the major causes of Postoperative complication gastric cancer.Methods:We performed a retrospective analysis of 289 patients with gastric cancer from 2005 to 2009 in YanBian University Hospital. Meanwhile, to investigate the preoperative conditions of patients, includes:age, gender, level of hemoglobinopathy, level of albumin, hepatitis B, liver function, heart function, lung function, hypertension, diabetes, diameter of tumor, location of tumor, depth of invasion, pattern of Borrmann, lymph node metastasis, pattern of operation, blood loss during operation, transfusion, time of operation. The variables maybe cause the postoperative complications, so we make a statistical analysis to them. Then the single factor analysis be used for all kinds of factors which can cause the postoperative complications.Results:.There are 46 of patients associate with complications in all of patients. The complications include:wound infection; lung infection of postoperative; abdominal cavity infection of postoperative; intestinal obstruction of postoperative; rapture of anastomosis. The result show that the postoperative complications are relate to those factors:1、The factors are relate to the patients:age, preoperative complications, level of hemoglobinopathy, level of albumin, liver function, heart function, lung function, hypertension, diabetes,2、The factors are relate to the pattern of the operation:pattern of operation, blood loss during operation, time of operation 3、The factors are relate to the pattern of the tumor of patient:diameter of tumor, depth of invasion, pattern of Borrmann, lymph node metastasis。Conclusion:1、The postoperative complications are caused by many factors.2、Reasonable the repair of preoperation and the pattern of operation are the key for decrease the postoperative complications. There are more postoperative complications for D2 operative pattern than D1.更多还原