【摘要】 目的 系统评价胃癌根治术后发生胃瘫综合征（PGS）的危险因素，为防治PGS提供理论支持。方法 通过计算机检索PubMed、Web of Science、The Cochrane Library、EMbase、万方、维普、中国知网和中国生物医学文献数据库，搜集胃癌根治术后发生PGS的危险因素的病例对照研究、队列研究。检索时限为建库至2021年10月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，使用RevMan5.4软件进行Meta分析。结果 共纳入28个研究，包括13 569例患者，其中胃瘫（PGS）组1025例，非胃瘫（nPGS）组12 544例。Meta分析显示：术前因素：年龄、年龄≥60岁、术前白蛋白<35 g/L、术前低蛋白血症、术前高血糖、糖尿病、高血压、术前焦虑、术前幽门梗阻、术前营养不良；术中因素：毕Ⅱ式吻合、开腹手术、手术时间>4 h、术中失血量>400 ml、D3淋巴结清扫；术后因素：术后高血糖、术后腹腔感染、腹腔并发症、应用止疼泵、应用阿片类止疼药物、应用非甾体止痛药物均是胃癌根治术后发生PGS的危险因素。结论 患者自身及围手术期致使胃癌根治术后发生PGS的危险因素较多，但受纳入研究质量限制，仍需更多高质量的文献予以佐证。更多还原

【Abstract】 Objective To systematically evaluate the risk factors of gastroparesis syndrome(PGS) after radical gastrectomy for gastric cancer, and to provide theoretical support for the prevention and treatment of PGS.Methods Case-control studies and cohort studies on the risk factors of PGS after radical gastrectomy for gastric cancer were collected by searching PubMed, Web of Science, The Cochrane Library, EMbase, Wanfang, VIP, CNKI and China Biomedical Literature Database. The retrieval time limit is from the establishment of the database to October 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan5.4 software.Results A total of 28 studies involving 13 569 patients were included, including 1025 patients in postsurgical gastroparesis syndrome(PGS) group and 12 544 patients in non-postsurgical gastroparesis syndrome gastroparesis(nPGS) group. Meta-analysis showed that preoperative factors: age, age ≥60 years old, preoperative albumin <35 g/L, preoperative hypoproteinemia, preoperative hyperglycemia, diabetes, hypertension,preoperative anxiety, preoperative pyloric obstruction, preoperative malnutrition; intraoperative factors: Billroth Ⅱ anastomosis, laparotomy, operation time >4 h, intraoperative blood loss >400 ml, D3 lymph node dissection; postoperative factors: postoperative hyperglycemia, postoperative abdominal infection, abdominal complications, application of analgesic pump, application of opioid analgesics, and application of non-steroidal analgesics were all risk factors for PGS after radical gastrectomy.Conclusion There are many risk factors for PGS after radical gastrectomy for gastric cancer in patients and perioperative period, but due to the limited quality of the included studies, more high-quality literature is still needed to support it.更多还原