大连医科大学学报
大連醫科大學學報
대련의과대학학보
JOURNAL OF DALIAN MEDICAL UNIVERSITY
2015年
2期
165-168
,共4页
感染%危险因素%胰十二指肠切除术
感染%危險因素%胰十二指腸切除術
감염%위험인소%이십이지장절제술
infection%risk factors%pancreaticoduodenectomy
目的：探讨胰十二指肠切除术（ pancreaticoduodenectomy，PD）后发生感染的相关危险因素。方法回顾性分析2009年1月—2014年6月收治的118例行PD术病人的临床资料，将发生感染的病人作为感染组（21例），未发生感染的病人作为对照组（97例），对两组病人的一般情况、术前、术中及术后相关指标进行单因素分析，并将单因素分析有统计学意义的因素纳入多因素Logistic回归分析。结果引起PD术后感染的细菌主要有大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌。单因素分析示两组病人术后胰瘘、术后白蛋白、手术时间、术前胆红素、术后血红蛋白、围手术期输血、术后空腹血糖之间的差异有显著性意义（P＜0．05）。多因素Logistic回归分析示，手术后胰瘘、术后低蛋白血症、手术时间、术后高血糖为PD术后发生感染的独立危险因素（P＜0．05）。结论 PD术中应缩短手术时间，预防术后胰瘘、低蛋白血症和高血糖，以避免术后感染发生。
目的：探討胰十二指腸切除術（ pancreaticoduodenectomy，PD）後髮生感染的相關危險因素。方法迴顧性分析2009年1月—2014年6月收治的118例行PD術病人的臨床資料，將髮生感染的病人作為感染組（21例），未髮生感染的病人作為對照組（97例），對兩組病人的一般情況、術前、術中及術後相關指標進行單因素分析，併將單因素分析有統計學意義的因素納入多因素Logistic迴歸分析。結果引起PD術後感染的細菌主要有大腸埃希菌、銅綠假單胞菌、肺炎剋雷伯菌、金黃色葡萄毬菌。單因素分析示兩組病人術後胰瘺、術後白蛋白、手術時間、術前膽紅素、術後血紅蛋白、圍手術期輸血、術後空腹血糖之間的差異有顯著性意義（P＜0．05）。多因素Logistic迴歸分析示，手術後胰瘺、術後低蛋白血癥、手術時間、術後高血糖為PD術後髮生感染的獨立危險因素（P＜0．05）。結論 PD術中應縮短手術時間，預防術後胰瘺、低蛋白血癥和高血糖，以避免術後感染髮生。
목적：탐토이십이지장절제술（ pancreaticoduodenectomy，PD）후발생감염적상관위험인소。방법회고성분석2009년1월—2014년6월수치적118례행PD술병인적림상자료，장발생감염적병인작위감염조（21례），미발생감염적병인작위대조조（97례），대량조병인적일반정황、술전、술중급술후상관지표진행단인소분석，병장단인소분석유통계학의의적인소납입다인소Logistic회귀분석。결과인기PD술후감염적세균주요유대장애희균、동록가단포균、폐염극뢰백균、금황색포도구균。단인소분석시량조병인술후이루、술후백단백、수술시간、술전담홍소、술후혈홍단백、위수술기수혈、술후공복혈당지간적차이유현저성의의（P＜0．05）。다인소Logistic회귀분석시，수술후이루、술후저단백혈증、수술시간、술후고혈당위PD술후발생감염적독립위험인소（P＜0．05）。결론 PD술중응축단수술시간，예방술후이루、저단백혈증화고혈당，이피면술후감염발생。
Objective To investigate infection-related risk factors after pancreaticoduodenectomy ( PD) .Methods Total-ly 118 patients,who received PD from 2009 January to 2014 June in our hospital,were retrospectively analyzed.21 patients developed infection after surgery and were included in infection group;the remainder non-infection patients were classified as control group (97 cases).General information,preoperative,intraoperative and postoperative factors of patients in two groups were analyzed by single factor analysis and multivariate Logistic regression analysis.Results Bacteria were the main source of infection after PD including mainly Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,and Staphy-lococcus aureus.Single factor analysis showed that postoperative pancreatic fistula,postoperative albumin,operation time, preoperative bilirubin,postoperative hemoglobin,peri-operation blood transfusion and fasting blood glucose after operation were significantly different (P<0.05).Multivariate Logistic regression analysis showed that pancreatic leakage after opera-tion,postoperative hypoproteinemia,operation time,postoperative hyperglycemia were independent risk factors of infection after PD (P<0.05).Conclusion It should be reducing the operation time and preventing pancreatic fistula,hypoproteine-mia and hyperglycemia after operation to reduce the incidence of postoperative infection of PD.
