CAJ | 학술논문

目的探讨胰十二指肠切除术后胃排空延迟发生的相关危险因素.方法回顾性分析解放军总医院2013年1月1日至2013年12月31日收治的196例胰十二指肠切除术患者的临床资料,对可能影响胃排空延迟发生的相关因素作单因素及多因素分析.结果 196例胰十二指肠切除术后发生各级胃排空延迟71例,发病率为36.2％.其中A级44例(22.4％),B级12例(6.1％),C级15例(7.7％).死亡3例,均为胰瘘后并发假性动脉瘤破裂出血引起的多脏器功能衰竭,病死率为1.5％.身体质量指数(BMI)、布朗吻合、临床胰瘘、腹腔积液与胃排空延迟发生有关,且BMI≥25 kg/m2、临床胰瘘、腹腔积液是胰十二指肠切除术后发生临床胃排空延迟的独立危险因素.结论胃排空延迟主要与术后并发症有关.早期诊断、及时有效处理胰瘘、腹腔积液等并发症,有助于减少胃排空延迟的发生并促进其恢复.
목적 탐토이십이지장절제술후위배공연지발생적상관위험인소.방법 회고성분석해방군총의원2013년1월1일지2013년12월31일수치적196례이십이지장절제술환자적림상자료,대가능영향위배공연지발생적상관인소작단인소급다인소분석.결과 196례이십이지장절제술후발생각급위배공연지71례,발병솔위36.2％.기중A급44례(22.4％),B급12례(6.1％),C급15례(7.7％).사망3례,균위이루후병발가성동맥류파렬출혈인기적다장기공능쇠갈,병사솔위1.5％.신체질량지수(BMI)、포랑문합、림상이루、복강적액여위배공연지발생유관,차BMI≥25 kg/m2、림상이루、복강적액시이십이지장절제술후발생림상위배공연지적독립위험인소.결론 위배공연지주요여술후병발증유관.조기진단、급시유효처리이루、복강적액등병발증,유조우감소위배공연지적발생병촉진기회복.
Objective To study the risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).Methods Between Ja(n)uary 1st 2013 and December 31st 2013,data from 196 consecutive patients who underwent PD at the Chinese PLA General Hospital were studied retrospectively.17 factors were examined.Univariate analysis and multivariate logistic regression analysis were used to determine the relative risks.Results DGE occurred in 71 patients (36.2％).The incidences of grade A,grade B and grade C DGE were 22.4％ (44/196),6.1％ (12/196) and 7.7％ (15/196) respectively.There were three postoperative deaths.The overall mortality rate was 1.5％.BMI,Braun anastomosis,clinically relevant postoperative pancreatic fistula (CR-POPF) and intra-abdominal collection were significantly correlated with DGE on univariate analyses.BMI ≥25 kg/m2,CR-POPF,and intra-abdominal collection were independent risk factors on univariate and multivariate regression analyses.Conclusions Post-operative complications were associated with DGE.Early diagnosis and timely treatment for pancreatic fistula and abdominal collection were helpful to decrease morbidity and to promote recovery of DGE.