中国普外基础与临床杂志

中国普外基础与临床杂志

远端胰腺切除术后胰瘘的危险因素分析

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目的 分析远端胰腺切除术(DP)术后胰瘘(POPF)发生的相关危险因素,探讨预测 DP 后 POPF 的有效因素。 方法 回顾性分析 2010 年 1 月至 2017 年 11 月期间于徐州医科大学附属医院肿瘤外科进行 DP 的 120 例胰腺疾病患者的临床资料,采用非条件 logistic 回归探索 DP 后 POPF 发生的影响因素。 结果 120 例患者中,有 15 例(12.5%)发生有临床意义的 POPF,其中 B 级胰瘘 13 例,C 级胰瘘 2 例。非条件 logistic 回归结果显示,胰腺质地软及术前胰腺 CT 值小于 40 Hu 为 DP 后发生 POPF 的独立危险因素(P<0.05)。 结论 胰腺质地及术前胰腺 CT 值是 DP 后 POPF 发生的重要影响因素,对术前患者的 CT 值及术中胰腺质地进行评估,可有效预测 DP 后胰瘘的风险。

Objective To analyze the risk factors of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) and to explore the effective index of predicting POPF after DP. Methods The clinical data of 120 patients with pancreatic disease who were treated with DP in Tumor Surgery Department of Xuzhou Medical University from January 2010 to November 2017 were analyzed retrospectively. The influencing factors of POPF after DP were analyzed by non-conditional logistic regression. Results Of the 120 patients, 15 patients (12.5%) had clinically significant POPF, including 13 cases of grade B pancreatic fistula and 2 cases of grade C pancreatic fistula. The non-conditional logistic regression showed that, the soft pancreas and preoperative pancreatic CT value of the pancreas was less than 40 Hu , which were the independent risk factors of POPF after DP (P<0.05). Conclusions Pancreatic texture and preoperative CT value were important factors influencing the occurrence of POPF after DP. Evaluating the preoperative CT value and intraoperative pancreatic texture can effectively predict the risk of POPF after DP.

关键词: 远端胰腺切除术; 胰瘘; 胰腺平扫CT值; 危险因素

Key words: distal pancreatectomy; postoperative pancreatic fistula; pancreatic plain scan CT value; risk factor

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