中国实用外科杂志2024，Vol.44Issue(5)：577-582,6.DOI:10.19538/j.cjps.issn1005-2208.2024.05.18
基于倾向性评分匹配分析腹腔镜结肠癌根治术后肠道菌群失调的临床特征和危险因素
The manifestations and risk factors of intestinal flora disorder after laparoscopic colon surgery:a single-center retrospective analysis
摘要
Abstract
Objective To investigate the clinical characteristics and risk factors of intestinal flora disorder(IFD)after laparoscopic radical coloectomy.Methods A retrospective analysis was conducted on clinical data from 1073 patients who underwent laparoscopic radical coloectomy in the Department of General Surgery,Peking Union Medical College Hospital,from January 2019 to October 2023.Patients were categorized into the IFD group(n=97)and the non-IFD group(n=194)based on the occurrence of IFD,after propensity score matching.The clinical characteristics of patients in the two groups were compared,and conditional logistic regression analysis of binary variables was applied to identify the risk factors of IFD.Results The most common manifestations of IFD were diarrhea(50 patients,51.5%)and abdominal distension(38 patients,39.2%).Most patients achieved clinical recovery after adjusting the intestinal flora and receiving anti-infective treatment,with 23 patients(23.7%)and 11 patients(11.3%)requiring gastric tube and intestinal obstruction tube decompression,respectively.The most common timing for tube placement was postoperative days 4-6(73.9%)and postoperative days 7-12(63.6%).Multivariate logistic regression analysis revealed that preoperative intestinal obstruction(OR=4.88,95%CI 1.17-20.39,P=0.030)and early postoperative antibiotic(OR=7.94,95%CI 2.19-28.74,P=0.002)were independent risk factors for IFD,while enteral nutrition support before surgery(OR=0.06,95%CI 0.02-0.19,P＜0.001)was a protective factor of IFD.Conclusion The most common manifestations of IFD were diarrhea and abdominal distension,most patients could be managed conservatively.For patients with preoperative intestinal obstruction or early postoperative antibiotics,attention should be paid to IFD.Simultaneous enteral nutrition prior to surgery may reduce the risk of IFD.关键词
结肠癌,腹腔镜手术/肠道菌群失调/临床特征/危险因素Key words
colorectal cancer,laparoscopic surgery/intestinal flora disorder/clinical characteristics/risk factors分类
医药卫生引用本文复制引用
李干斌,徐徕,吴斌,肖毅,邱辉忠,林国乐,王晨童,张潇,邱小原,陈伟杰,张冠南,孙曦羽,牛备战,陆君阳..基于倾向性评分匹配分析腹腔镜结肠癌根治术后肠道菌群失调的临床特征和危险因素[J].中国实用外科杂志,2024,44(5):577-582,6.基金项目
中央高水平医院临床科研专项(No.2022-PUMCH-C-005) （No.2022-PUMCH-C-005）
中央高水平医院临床科研专项2022年专科提升计划"消化道肿瘤诊治精准化体系的建立"(No.2022-PUMCH-B-005) （No.2022-PUMCH-B-005）
