粘连性小肠梗阻术后早期小肠梗阻危险因素分析

Risk Factors for Early Postoperative Small Bowel Obstruction after Adhesive Small Bowel Obstruction Surgery

摘要: 目的：探讨粘连性小肠梗阻发生术后早期小肠梗阻(Early postoperative small bowel obstruction, EPSBO)的危险因素。方法：回顾性分析2023年1月至2024年12月期间在青岛大学附属医院接受粘连性小肠梗阻手术治疗的256例患者的临床数据。根据是否发生术后早期小肠梗阻，将患者分为两组：EPSBO组和非EPSBO组。通过单因素和多因素Logistic回归分析，分析粘连性小肠梗阻术后早期小肠梗阻危险因素。结果：共纳入256例患者，EPSBO的发生率为12.50% (32/256)。在单因素分析中，术前低血清白蛋白水平(P < 0.001)、手术时间长(P = 0.020)、腹水(P = 0.007)、肠壁水肿(P = 0.030)与EPSBO的发生差异有统计学意义。将上述临床因素纳入多因素Logistic回归分析结果显示，术前低白蛋白水平(OR = 0.91, 95%CI: 0.86~0.97)、肠壁水肿(OR = 2.71, 95%CI: 1.09~6.78)和腹水(OR = 2.83, 95%CI: 1.26~6.36)是发生术后早期小肠梗阻的独立危险因素。结论：术前低白蛋白水平、肠壁水肿和腹水是早期预测粘连性小肠梗阻术后发生早期小肠梗阻的重要指标。

Abstract: Purpose: This study aims to determine risk factors for early postoperative small bowel obstruction (EPSBO) following adhesive small bowel obstruction. Methods: A retrospective analysis was conducted on the clinical data of 256 patients who underwent surgical treatment for adhesive small bowel obstruction (ASBO) at Qingdao University Affiliated Hospital between January 2023 and December 2024. The patients were divided into two groups based on the occurrence of early postoperative small bowel obstruction (EPSBO): the EPSBO group and the non-EPSBO group. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for early postoperative small bowel obstruction following adhesive small bowel obstruction surgery. Results: A total of 256 patients were included in the study, with an incidence of early postoperative small bowel obstruction (EPSBO) of 12.50% (32/256). Univariate analysis revealed that preoperative low serum albumin levels (P < 0.001), prolonged surgery duration (P = 0.020), ascites (P = 0.007), and bowel wall edema (P = 0.030) were statistically significant factors associated with the occurrence of EPSBO. Multivariate logistic regression analysis, incorporating these clinical factors, showed that preoperative low albumin levels (OR = 0.91, 95% CI: 0.86~0.97), bowel wall edema (OR = 2.71, 95% CI: 1.09~6.78), and ascites (OR = 2.83, 95% CI: 1.26~6.36) were independent risk factors for the development of early postoperative small bowel obstruction. Conclusion: Preoperative low albumin levels, bowel wall edema, and ascites are important indicators for the early prediction of the occurrence of early postoperative small bowel obstruction following adhesive small bowel obstruction surgery.