| Objective:By analyzing the case data and biochemical examination of patients with intestinal obstruction after radical gastrectomy of malignant tumor,this paper discusses the risk factors of postoperative intestinal obstruction and the factors of malignant intestinal obstruction,so as to provide certain help for clinical work to prevent the occurrence of intestinal obstruction and distinguish benign and malignant intestinal obstruction.Methods: The data of patients who underwent radical gastrectomy for gastrointestinal malignant tumor in Yijishan Hospital of Wannan Medical College from June 2015 to December 2018 and were pathologically confirmed to be malignant tumor without distant metastasis were collected.1905 cases with statistical gastrointestinal malignant tumor radical surgery,postoperative intestinal obstruction patients a total of 91 cases,with 91 cases patients group,the male 63,female 28 people,age(64.07+9.91),with age,sex,as covariate surgery from the same period,there was no intestinal obstruction patients from182 cases as control group,were retrospectively matching study,Statistical univariate and multivariate analysis methods were used to explore the risk factors of intestinal obstruction after gastrointestinal malignant tumor operation.A total of 91 cases of postoperative intestinal obstruction were analyzed and divided into two groups,including32 cases of neoplastic intestinal obstruction group and 59 cases of non-neoplastic intestinal obstruction group.Relevant data were also analyzed by statistical analysis to explore the factors of malignant intestinal obstruction after radical resection of gastrointestinal malignant tumors.Results: 1.Risk factors for postoperative intestinal obstruction of gastrointestinal malignant tumor: Univariate analysis:In case group and control group,smoking history(P=0.75),drinking history(P=0.80),history of diabetes(P=0.25),history of chronic obstructive pulmonary disease(P=0.50),ASA score(P=0.41),history of hypertension(P=0.47),albumin(P=0.60),hemoglobin(P=0.82),operative time(P=0.82)were measured=0.59),the number of intraoperative bleeding(P=1.00),the longest diameter of the tumor(P=0.12),and the presence of blood transfusion(P=0.63)were not statistically significant(P>0.05);The surgical method(P= 0.00),cardiovascular history(P=0.02),combined resection of viscera(P=0.03),and tumor stage(P= 0.00)had statistical significance(P <0.05).Multivariate analysis showed that combined visceral resection(OR=3.239,CI=1.056-9.938,P=0.04)and late tumor staging(OR=2.249,CI=1.299-3.896,P=0.004)were the risk factors for intestinal obstruction after radical gastrectomy of gastrointestinal malignant tumor.Laparoscopic surgery(OR=0.389,CI=0.224-0.674,P=0.001)was a protective factor for intestinal obstruction after radical gastrectomy for gastrointestinal malignancy.2.Comparative analysis of benign and malignant intestinal obstruction after gastrointestinal malignancy: there were no statistically significant differences in gender(P=0.58),age(P=0.57),longest tumor diameter(P=0.89),and primary tumor site(P=0.48)(P>0.05),the obstruction time(P=0.001),the degree of tumor differentiation(P=0.034),and the stage of tumor(P=0.00)were statistically significant(P<0.05).Multivariate analysis showed that postoperative malignant intestinal obstruction after radical gastrectomy for gastrointestinal malignant tumor was more common in patients with obstruction time ≥6 months(OR=3.49,CI=1.012-12.043,P=0.048)and with late tumor staging(OR=9.22,CI=2.787-30.483,P=0.000).Conclusion: Combined visceral resection and late tumor staging were the risk factors for intestinal obstruction after radical gastrectomy,and laparoscopic surgery was the independent protective factor.Malignant intestinal obstruction after radical gastrectomy for malignant intestinal neoplasms Intestinal obstruction usually occurs in patients with an obstruction time ≥6 months and a late tumor stage. |
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