摘要：

目的: 探讨老年口腔颌面部恶性肿瘤患者术后应激性溃疡出血的高危因素。方法: 选取2014年12月—2018年12月期间我院收治的老年口腔颌面部恶性肿瘤患者共480例作为研究对象，观察患者术后应激性溃疡出血发生情况。采用单因素分析影响术后应激性溃疡出血的相关因素；多因素Logistic回归分析影响术后应激性溃疡出血的高危因素。调查因素包括性别、饮酒史、吸烟史、合并高血压、合并糖尿病、体质指数、淋巴结转移情况、术前白蛋白水平、手术时间、术中出血量。结果: 480例老年口腔颌面部恶性肿瘤患者中，发生术后应激性溃疡出血23例，发生率为4.79%。单因素分析结果显示，2组性别、吸烟史、合并高血压、合并糖尿病、体质量指数和术中出血量比较差异无统计学意义（P>0.05）；2组饮酒史、淋巴结转移情况、术前白蛋白水平和手术时间比较，差异具有统计学意义（P<0.05）。上述单因素分析结果显示，饮酒史、淋巴结转移情况、术前白蛋白水平和手术时间为影响术后应激性溃疡出血的高危因素。结论: 老年口腔颌面部恶性肿瘤患者术后应激性溃疡出血受多种因素影响，其中饮酒史、淋巴结转移情况、术前白蛋白水平和手术时间为其高危因素。

关键词: 口腔颌面部恶性肿瘤, 术后应激性溃疡出血, 高危因素

Abstract:

Objective: The goal of this study was to search for the risk factors of postoperative stress hemorrhage of peptic ulcer(SHPU) in elderly patients with oral and maxillofacial malignant tumors. Methods: A total of 480 elderly patients with oral and maxillofacial malignant tumors admitted to our hospital from December 2014 to December 2018 were selected, and the occurrence of SHPU after operation was observed. Univariate analysis was used to analyze the related factors affecting SHPU after operation, and multivariate Logistic regression was used to analyze the high risk factors affecting SHPU after operation. The factors included gender, drinking history, smoking history, hypertension, diabetes mellitus, body mass index, lymph node metastasis, preoperative albumin, operation time and intraoperative bleeding volume. Results: Among 480 patients, 23 patients were suffered from SHPU after operation, and the incidence rate was 4.79%. The univariate analysis results showed that there were no significant differences in gender, smoking history, hypertension, diabetes mellitus, body mass index and intraoperative bleeding amount between the two groups (P>0.05); but there were significant differences in smoking history, lymph node metastasis, preoperative albumin volume and operation time between the two groups (P<0.05). The single factor analysis showed that drinking history, lymph node metastasis, preoperative albumin and operation time were the high risk factors of SHPU after operation. Conclusion: Postoperative SHPU in elderly patients with oral and maxillofacial malignant tumors is affected by many factors. Furthermore, drinking history, lymph node metastasis, preoperative albumin volume and operation time are the high risk factors.

Key words: oral and maxillofacial malignant tumors, postoperative stress ulcer bleeding, high risk factors