Tian Weiliang, Yan Ming, Xu Xin, Yao Zheng, Zhao Risheng
Department of General Surgery, Jinling Hospital, Nanjing, China.
Department of General Surgery, Nanjing Jiangning Hospital, Nanjing, China.
Front Surg. 2021 Feb 19;8:632241. doi: 10.3389/fsurg.2021.632241. eCollection 2021.
The study aimed to investigate the risk factors for postoperative ileus (POI) after small intestinal fistula excision (SIFE) in patients with diffuse extensive abdominal adhesions. From October 2010 to December 2019, we enrolled patients who underwent SIFE and had diffuse extensive abdominal adhesions. Patients were divided into the POI group and the non-POI group according to its occurrence. We then investigated and analyzed the clinical characteristics of both groups. A total of 247 patients were enrolled into the study. There were 100 patients in the POI group, and 147 patients in the non-POI group. A multi-variable logistic regression analysis revealed that blood loss during SIFE (OR = 1.001; 95% CI: 1.000-1.259; = 0.012), postoperative lactate(OR = 1.212; 95% CI: 1.001-1.304; = 0.015), grade V abdominal adhesions (OR = 2.518; 95% CI: 1.814-3.44; = 0.024), and time for recovery of lactate <2 mmol/L (OR = 2.079; 95% CI: 1.599-3.616; = 0.026) were associated with POI. Moreover, POI was also associated with prolonged postoperative stay in the hospital (HR = 3.291; 95% CI: 2.511-4.172; = 0.014). Blood loss during operation, grade V abdominal adhesions, positive fluid balance within 48 h of operation, and time for recovery of lactate were the risk factors for POI after SIFE in patients with diffuse extensive abdominal adhesions.
本研究旨在探讨弥漫性广泛腹腔粘连患者小肠瘘切除术后肠麻痹（POI）的危险因素。2010年10月至2019年12月，我们纳入了接受小肠瘘切除术且有弥漫性广泛腹腔粘连的患者。根据是否发生POI将患者分为POI组和非POI组。然后我们对两组的临床特征进行了调查和分析。共有247例患者纳入本研究。POI组100例，非POI组147例。多变量逻辑回归分析显示，小肠瘘切除术中失血（OR = 1.001；95%CI：1.000-1.259；P = 0.012）、术后乳酸水平（OR = 1.212；95%CI：1.001-1.304；P = 0.015）、Ⅴ级腹腔粘连（OR = 2.518；95%CI：1.814-3.44；P = 0.024）以及乳酸恢复至<2 mmol/L的时间（OR = 2.079；95%CI：1.599-3.616；P = 0.026）与POI相关。此外，POI还与术后住院时间延长有关（HR = 3.291；95%CI：2.511-4.172；P = 0.014）。手术失血、Ⅴ级腹腔粘连、术后48小时内液体平衡为正以及乳酸恢复时间是弥漫性广泛腹腔粘连患者小肠瘘切除术后POI的危险因素。
