胰十二指肠切除术后腹腔感染的多因素Logistic回归分析及风险评估

发布时间：2018-05-07 12:02

本文选题：胰十二指肠切除术 + 腹腔感染　；参考：《中国煤炭工业医学杂志》2016年12期

【摘要】：目的探讨胰十二指肠切除术后腹腔感染的发生率及其高危因素。方法回顾性分析2014年1月—2015年12月行胰十二指肠切除和Child法消化道重建128例患者的临床资料,通过单因素分析与多因素分析方法筛选出与PD术后发生腹腔感染相关的因素,并建立腹腔感染的风险预测模型,应用受试者工作特征曲线(ROC曲线)对该系统检验效能进行评价。结果 128例胰十二指肠切除术后发生腹腔感染52例,发病率为40.6%。单因素分析结果显示术前黄疸1个月、胰瘘、腹腔积液为危险因素;进一步将其纳入多因素Logistic回归分析,提示三者均为腹腔感染的独立危险因素。根据回归系数建立术后腹腔感染风险预测模型,评分系统的ROC曲线下面积为0.716±0.046(P0.05)。结论胰十二指肠切除术后腹腔感染的发生与术前黄疸时间、胰瘘和术后腹腔积液密切相关,根据回归方程建立的风险预测模型能够较好的预测胰十二指肠切除术后腹腔感染的发生,术后应重视预防和早期诊治。
[Abstract]:Objective to investigate the incidence and high risk factors of abdominal infection after pancreaticoduodenectomy. Methods the clinical data of 128 patients with pancreaticoduodenectomy and Child digestive tract reconstruction from January 2014 to December 2015 were retrospectively analyzed. The factors associated with abdominal infection after PD were screened by univariate analysis and multivariate analysis. The risk prediction model of abdominal infection was established, and the test effectiveness of the system was evaluated by using the operating characteristic curve and ROC curve. Results there were 52 cases of abdominal infection after pancreaticoduodenectomy, and the incidence was 40.6%. The results of univariate analysis showed that preoperative jaundice, pancreatic fistula and peritoneal effusion were risk factors, which were further analyzed by multivariate Logistic regression analysis, which indicated that the three factors were independent risk factors of abdominal infection. According to the regression coefficient, a prediction model of postoperative abdominal infection risk was established. The area under the ROC curve of the scoring system was 0.716 卤0.046 (P 0.05). Conclusion the incidence of intraperitoneal infection after pancreaticoduodenectomy is closely related to preoperative jaundice time, pancreatic fistula and postoperative peritoneal effusion. The risk prediction model based on regression equation can predict the incidence of abdominal infection after pancreaticoduodenectomy. Prevention and early diagnosis and treatment should be paid attention to after operation.
【作者单位】：安徽医科大学附属安徽省立医院普外科;
【基金】：安徽省科技计划项目(编号:1506c085018) 安徽省自然科学基金(编号:1408085QH188)
【分类号】：R657.5

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