【摘要】 目的 分析抗反流术后患者并发胃肠道功能紊乱的影响因素，探讨预防抗反流术后并发胃肠道功能紊乱的对策。方法 回顾性分析2017年2月至2019年1月浙江省人民医院收治的行内镜下抗反流手术（EART）治疗的138例胃食管反流（GERD）患者临床资料，将术后未发生胃肠道功能紊乱的84例患者设为对照组，术后发生胃肠道功能紊乱的54例患者设置为观察组；对两组患者的人口学资料、疾病资料、治疗护理资料进行整理分类，并行单因素分析，将差异有统计学意义的因素行多因素logistic分析。结果 （1）54例GERD患者行EART术后并发胃肠道功能紊乱以便秘症状为主，其次为腹胀、腹泻。（2）经单因素分析，两组患者年龄、BMI、术前烧心症状评分、术前泛酸症状评分、术前高血压、合并食管裂孔疝、术前对PPI药物敏感、社会支持度评分、汉密尔顿焦虑评分、汉密尔顿抑郁评分、术前LSP、UESP、手术医师年资、术后下床时间差异有统计学意义（P<0.05）；（3）多因素logistic显示，BMI>24 kg/m2、合并食管裂孔疝、社会支持度评分<20分、术后下床时间>48 h为胃食管反流病患者EART术后并发胃肠道功能障碍高危因素。结论 胃食管反流病行EART手术治疗的患者术后并发为肠道功能障碍影响因素多，临床应加强患者心理情控制及术后干预以改善其并发胃肠道功能紊乱。更多还原

【Abstract】 Objective To analyze the influencing factors of the complication of gastrointestinal dysfunction after antireflux surgery, and to explore the countermeasures to prevent gastrointestinal dysfunction after anti-reflux surgery.Methods The clinical data of 139 patients with gastroesophageal reflux disease（GERD）admitted to Zhejiang Provincial People′s Hospital to undergo endoscopic anti-reflux therapy（EART） were retrospectively analyzed. A total of 84 patients without postoperative gastrointestinal dysfunction were set as the control group, and 54 patients with postoperative gastrointestinal dysfunction were set as the observation group. The demographic data, disease data, treatment and nursing data of the two groups of patients were sorted and classified, univariate analysis was performed, and multivariate logistic analysis was performed on the factors with statistically significant differences.. Results（1）A total of 54 cases of patients with GERD undergoing EART had postoperative gastrointestinal dysfunction mainly featured by constipation,followed byabdominal distension and diarrhea.（2）According to the univariate analysis, there were statistically significant differences between the two groups of patients in age, body mass index（BMI）, preoperative heartburn symptom score,preoperative pantothenic acid symptom score, preoperative hypertension, complications of esophageal hiatal hernia, preoperative sensitivity to proton pump inhibitors（PPI）, social support score, Hamilton anxiety score, Hamilton depression score, preoperative LSP, UESP, seniority of surgeon, and postoperative out-of-bed time（P<0.05）.（3）Multivariate logistic analysis showed that BMI >24 kg/m~2, complications of esophageal hiatal hernia, social support score <20 points,postoperative out-of-bed time >48 h were high risk factors for gastrointestinal dysfunction in patients with GERD after EART. Conclusion There are many influencing factors of the postoperative complication of intestinal dysfunction for patients with GERD undergoing EART surgery. The clinical psychological control for patients and postoperative intervention should be strengthened to improve their complication of gastrointestinal dysfunction.更多还原