摘要
背景与目的:胰瘘是胰体尾切除(DP)术后最常见并发症,其与患者的预后及转归有着密切的关系。因此,本研究在探讨DP术后胰瘘发生情况及其影响因素,为制订防治措施提供依据。方法:回顾性分析2015年1月—2021年2月中国人民解放军空军军医大学第二附属医院收治的99例因胰腺肿瘤行DP术患者的临床资料,统计患者术后胰瘘的发生率,对可能导致术后胰瘘发生的相关因素行单因素及多因素Logistic回归分析。结果:99例患者DP术后生化漏发生率为34.3%(34/99),B级胰瘘发生率18.2%(18/99),C级胰瘘发生率1.0%(1/99)。单因素分析结果示,年龄、手术时间、胰管直径及是否联合脾切与胰瘘发生明显有关(均P<0.05),多因素Logistic回归分析结果示,年龄<42岁(OR=0.955,95%CI=0.914~0.998)、手术时间≥253 min (OR=1.013,95%CI=1.005~1.021)及联合脾切术(OR=4.152,95%CI=1.043~16.535)为DP术后胰瘘的独立危险因素(均P<0.05)。结论:DP术后有一定的胰瘘发生率,年龄、手术时间、联合脾切是DP术后胰瘘的独立危险因素。这些危险因素评估对术后胰瘘的风险预测及防范措施的制定提供了一定的依据。
Background and Aims: Pancreatic fistula is the most common complication after distal pancreatectomy(DP), and it is closely related to the patient’s prognosis and outcome. Therefore, this study was conducted to investigate the occurrence of postoperative pancreatic fistula after DP and the risk factors, so as to provide a basis for developing the protective measures.Methods: The clinical data of 99 patients undergoing DP for pancreatic tumors in the Second Affiliated Hospital of Air Force Medical University from January 2015 to February 2021 were retrospectively analyzed. The incidence rate postoperative pancreatic fistula was calculated, and relevant factors possibly causing postoperative of pancreatic fistula were determined by univariate and multivariate Logistic regression analysis.Results: In the 99 patients after DP, the incidence of biochemical leakage was 34.3%(34/99), grade B pancreatic fistula was 18.2%(18/99), and grade C pancreatic fistula was 1.0%(1/99), respectively. The results of univariate analysis showed that age, operative time, pancreatic duct diameter and undergoing combined splenectomy or not were significantly related to postoperative pancreatic fistula(all P<0.05). Multivariate Logistic regression analysis results revealed that age <42 years(OR=0.955, 95% CI=0.914-0.998), operative time ≥ 253 min(OR=1.013, 95% CI=1.005-1.021) and combined splenectomy(OR=4.152, 95% CI=1.043-16.535) were independent risk factors for postoperative pancreatic fistula after DP(all P<0.05).Conclusion: There is certain incidence rate of pancreatic fistula after DP. Age, operative time, and synchronous splenectomy are independent risk factors for pancreatic fistula after DP. Assessment of these factors may provide certain basis for predicting the risk of postoperative pancreatic fistula and implementing the prevention measures.
作者
王健
魏伏
段东峰
惠立良
王成果
鲁建国
WANG Jian;WEI Fu;DUAN Dongfeng;HUI Liliang;WANG Chengguo;LU Jianguo(Department of General Surgery,the Second Affiliated Hospital of Air Force Medical University,Xi'an Shaanxi 710038,China;Department of Intensive Care Unit,Xi'an People's Hospital(Xi'an Fourth Hospital),Xi'an,Shaanxi 710004,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2021年第9期1040-1046,共7页
China Journal of General Surgery
基金
国家青年科学基金资助项目(81001087)
陕西省重点研发基金资助项目(2018SF-154)。
关键词
胰腺切除术
胰腺肿瘤
胰腺瘘
危险因素
Pancreatectomy
Pancreatic Neoplasms
Pancreatic Fistula
Risk Factors
