中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2009年
10期
752-754
,共3页
李新%董明%周建平%李昱骥%孔凡民%田雨霖
李新%董明%週建平%李昱驥%孔凡民%田雨霖
리신%동명%주건평%리욱기%공범민%전우림
胰十二指肠切除术%危险因素%胰瘘
胰十二指腸切除術%危險因素%胰瘺
이십이지장절제술%위험인소%이루
Pancreaticoduodenectomy%Risk factors%Pancreatic fistula
目的 探讨胰十二指肠切除术后胰瘘发生的相关危险因素.方法 回顾性分析2001年6月至2006年6月间97例采用标准胰腺十二指肠切除术(PD)和传统Child法消化道重建患者的临床资料,分别对围手术期可能与胰瘘发生相关的因素进行分析比较.通过单因素分析与多因素分析筛选出与PD术后胰瘘发生相关的因素. 结果 97例PD术后患者中,发生胰瘘13例.单因素分析结果显示,术前血清胆红素水平≥170 mmol/L(P=0.038)、手术时间(P=0.003)、胃肠吻合口下方输入段与输出段之间加做Braun吻合(P=0.034)及术后预防性应用生长抑素(P=0.003)与PD术后胰瘘的发生相关;多因素分析结果显示,术前血清胆红素水平≥170 mmol/L(OR=11.687,P=0.021)是术后胰瘘发生的独立危险因素,而术后预防性应用生长抑素(OR=0.056,P=0.016)是胰瘘发生的保护因素. 结论 术前血清胆红素水平≥170 mmol/L是PD术后胰瘘发生的危险因素,术后预防性应用生长抑素可以减少胰瘘的发生.
目的 探討胰十二指腸切除術後胰瘺髮生的相關危險因素.方法 迴顧性分析2001年6月至2006年6月間97例採用標準胰腺十二指腸切除術(PD)和傳統Child法消化道重建患者的臨床資料,分彆對圍手術期可能與胰瘺髮生相關的因素進行分析比較.通過單因素分析與多因素分析篩選齣與PD術後胰瘺髮生相關的因素. 結果 97例PD術後患者中,髮生胰瘺13例.單因素分析結果顯示,術前血清膽紅素水平≥170 mmol/L(P=0.038)、手術時間(P=0.003)、胃腸吻閤口下方輸入段與輸齣段之間加做Braun吻閤(P=0.034)及術後預防性應用生長抑素(P=0.003)與PD術後胰瘺的髮生相關;多因素分析結果顯示,術前血清膽紅素水平≥170 mmol/L(OR=11.687,P=0.021)是術後胰瘺髮生的獨立危險因素,而術後預防性應用生長抑素(OR=0.056,P=0.016)是胰瘺髮生的保護因素. 結論 術前血清膽紅素水平≥170 mmol/L是PD術後胰瘺髮生的危險因素,術後預防性應用生長抑素可以減少胰瘺的髮生.
목적 탐토이십이지장절제술후이루발생적상관위험인소.방법 회고성분석2001년6월지2006년6월간97례채용표준이선십이지장절제술(PD)화전통Child법소화도중건환자적림상자료,분별대위수술기가능여이루발생상관적인소진행분석비교.통과단인소분석여다인소분석사선출여PD술후이루발생상관적인소. 결과 97례PD술후환자중,발생이루13례.단인소분석결과현시,술전혈청담홍소수평≥170 mmol/L(P=0.038)、수술시간(P=0.003)、위장문합구하방수입단여수출단지간가주Braun문합(P=0.034)급술후예방성응용생장억소(P=0.003)여PD술후이루적발생상관;다인소분석결과현시,술전혈청담홍소수평≥170 mmol/L(OR=11.687,P=0.021)시술후이루발생적독립위험인소,이술후예방성응용생장억소(OR=0.056,P=0.016)시이루발생적보호인소. 결론 술전혈청담홍소수평≥170 mmol/L시PD술후이루발생적위험인소,술후예방성응용생장억소가이감소이루적발생.
Objective To analysis the risk factors of pancreatic fistula after pancreaticoduodenectomy(PD). Methods A retrospective clinical study had been done in 97 patients who underwent PD between June 2001 and June 2006.The two groups were first compared by the univariate analysis;logistic regression was then used to determine the effect of multiple factors on pancreatic fistula.A P-value of less than 0.05 was considered to be statistically significant.Results Of the 97 patients,13 patients were identified as having pancreatic fistula.Factors significantly increasing the risk of pancreatic fistula by univariate analysis included preoperative serum total bilirubin(P=0.038),operative time(P=0.003) and whether or not Braun anastomosis(P=0.034),and prophylactic use of somatostatin(P=0.003) after operation.A multivariate logistic regression analysis revealed the factors most highly associated with pancreatic fistula to be preoperative serum total bilirubin (OR=11.687,P=0.021) and postoperative prophylactic use of somatostatin(OR=0.056,P=0.020).Conclusions Preoperative serum total bilirubin more than 170 mmol/L was a risk factor of pancreatic fistula after PD,and postoperative prophylactic use of somatostatin was a protect factor of pancreatic fistula after PD.
