临床医药实践
臨床醫藥實踐
림상의약실천
PROCEEDING OF CLINICAL MEDICINE
2014年
9期
648-651
,共4页
郭文科%贾彬%闫慧明%申素纲
郭文科%賈彬%閆慧明%申素綱
곽문과%가빈%염혜명%신소강
胰腺损伤%胰瘘%危险因素
胰腺損傷%胰瘺%危險因素
이선손상%이루%위험인소
pancreatic trauma%pancreatic fistula%risk factors
目的：探讨胰腺损伤术后胰瘘发生的危险因素。方法：回顾性分析2000年3月-2013年11月收治的胰腺损伤行手术治疗的59例患者的临床资料，按照胰瘘的诊断标准分为胰瘘组与无胰瘘组，并对围术期可能与胰瘘有关的8个因素进行单因素分析，将两组间差异有统计学意义的因素纳入Logistic多因素分析，探讨胰腺损伤术后发生胰瘘的独立危险因素。结果：59例患者术后发生胰瘘24例，发生率40.7%，其中胰外瘘18例，胰腺假性囊肿6例。单因素分析显示伤后至手术时间、淀粉酶变化增高趋势、胰腺损伤级别3个因素两组间比较差异有统计学意义，将上述3因素纳入Logistic多因素回归模型中，进行Logistic多因素分析，保留在Logistic多因素回归模型中的因素为伤后至手术时（OR=6.654），胰腺损伤级别（OR=8.393），术后引流液淀粉酶变化呈增高趋势（OR=12.883）。结论：伤后至手术时间≥12 h，胰腺损伤级别为Ⅲ级或Ⅲ级以上，术后淀粉酶值变化呈增高趋势是胰腺外伤术后胰瘘发生的独立危险因素。
目的：探討胰腺損傷術後胰瘺髮生的危險因素。方法：迴顧性分析2000年3月-2013年11月收治的胰腺損傷行手術治療的59例患者的臨床資料，按照胰瘺的診斷標準分為胰瘺組與無胰瘺組，併對圍術期可能與胰瘺有關的8箇因素進行單因素分析，將兩組間差異有統計學意義的因素納入Logistic多因素分析，探討胰腺損傷術後髮生胰瘺的獨立危險因素。結果：59例患者術後髮生胰瘺24例，髮生率40.7%，其中胰外瘺18例，胰腺假性囊腫6例。單因素分析顯示傷後至手術時間、澱粉酶變化增高趨勢、胰腺損傷級彆3箇因素兩組間比較差異有統計學意義，將上述3因素納入Logistic多因素迴歸模型中，進行Logistic多因素分析，保留在Logistic多因素迴歸模型中的因素為傷後至手術時（OR=6.654），胰腺損傷級彆（OR=8.393），術後引流液澱粉酶變化呈增高趨勢（OR=12.883）。結論：傷後至手術時間≥12 h，胰腺損傷級彆為Ⅲ級或Ⅲ級以上，術後澱粉酶值變化呈增高趨勢是胰腺外傷術後胰瘺髮生的獨立危險因素。
목적：탐토이선손상술후이루발생적위험인소。방법：회고성분석2000년3월-2013년11월수치적이선손상행수술치료적59례환자적림상자료，안조이루적진단표준분위이루조여무이루조，병대위술기가능여이루유관적8개인소진행단인소분석，장량조간차이유통계학의의적인소납입Logistic다인소분석，탐토이선손상술후발생이루적독립위험인소。결과：59례환자술후발생이루24례，발생솔40.7%，기중이외루18례，이선가성낭종6례。단인소분석현시상후지수술시간、정분매변화증고추세、이선손상급별3개인소량조간비교차이유통계학의의，장상술3인소납입Logistic다인소회귀모형중，진행Logistic다인소분석，보류재Logistic다인소회귀모형중적인소위상후지수술시（OR=6.654），이선손상급별（OR=8.393），술후인류액정분매변화정증고추세（OR=12.883）。결론：상후지수술시간≥12 h，이선손상급별위Ⅲ급혹Ⅲ급이상，술후정분매치변화정증고추세시이선외상술후이루발생적독립위험인소。
Objective:To discusse the risk factors of pancreatic fistula after operative management of pancreatic trauma. Methods:Fifty-nine patients of pancreatic trauma received operative management in the second clinical hospital of shanxi medical university. from March 2000 to November 2003 was analyzed. Eight single risk factors for pancreatic fistula of perioper-ative period were univariate analyzed,and the independent risk factors for pancreatic fistula of perioperative period were screened and included in a multivariate Logistic regression for analysis. Results:All of the 59 patients,the pancreatic fistula was 24(40. 7%),and pancreatic external fistula occurred in18 of patients,and pancreatic pseudocyst occurred in 6 patients, single factor analysis showed that,the time between injury and operative,and increased value of amylase of fluid drainage,and the degree of pancreas injury was significantly different between two group. The above three of factors have been introduced into the multiple factors Logistic models which shows that the time between injury and operative≥12 h(OR=6. 654),the degree of pancreas injury exceeding classⅢ(OR= 8. 393),increased value of amylase of fluid drainage(OR=12. 883)were independ-ent risk factors for pancreatic fistula. Conclusion:the time between injury and operative≥12 h,the degree of pancreas injury exceeding classⅢ,increased value of amylase of fluid drainage predict a high probability of pancreatic fistula after operative management of pancreatic trauma.
