胰十二指肠切除术后胰瘘预测指标的多因素分析

发布时间：2018-07-31 16:49

【摘要】：目的:胰瘘是胰十二指肠切除术后的一种严重并发症,且发生率较高,严重影响了患者的健康恢复。本研究通过对我院胰十二指肠切除术后患者相关指标的统计分析,探讨术后早期监测指标对胰瘘的预测价值,对于早期预测术后并发症并采取相关预防措施意义重大。方法:回顾性分析吉林大学第二医院肝胆胰外科2013年1月到2016年12月116例胰头十二指肠切除术患者的临床资料,根据国际胰瘘研究小组提出的胰瘘定义,将胰十二指肠切除术后前3天血清淀粉酶、引流液淀粉酶、血白细胞、血清白蛋白及C反应蛋白及相关指标的变化趋势进行单因素分析,多因素分析以胰瘘和非胰瘘作为因变量,胰瘘的相关预测指标作为自变量,采用二元Logistic回归分析。结果:接受胰十二指肠切除术患者共116例,其中16例患者术后发生胰瘘,胰瘘发生率为13.8%,死亡2人,胰瘘病死率12.5%,Logistic回归分析表明术后第1天腹腔引流液淀粉酶和血淀粉酶水平、术后第3天血清白蛋白水平是胰瘘的独立危险因素。结论:胰十二指肠切除术后第1天腹腔引流液淀粉酶和血淀粉酶、术后第3天血清白蛋白水平对胰瘘有重要的预测意义。
[Abstract]:Objective: pancreatic fistula is a serious complication after pancreatoduodenectomy. Through the statistical analysis of the related indexes of patients after pancreaticoduodenectomy in our hospital, the predictive value of early monitoring indexes for pancreatic fistula was discussed, which is of great significance for early prediction of postoperative complications and relevant preventive measures. Methods: the clinical data of 116 patients undergoing pancreaticoduodenectomy from January 2013 to December 2016 in the Department of Hepatobiliary and Pancreatic surgery in the second Hospital of Jilin University were retrospectively analyzed. The changes of serum amylase, drainage fluid amylase, white blood cell, serum albumin, C-reactive protein and related indexes were analyzed by single factor analysis 3 days before pancreaticoduodenectomy. Multivariate analysis of pancreatic fistula and non-pancreatic fistula as dependent variables, pancreatic fistula related predictors as independent variables, using binary Logistic regression analysis. Results: there were 116 patients undergoing pancreaticoduodenectomy, 16 of them had pancreatic fistula, the incidence of pancreatic fistula was 13.8. the fatality rate of pancreatic fistula was 12.5. logistic regression analysis showed that amylase and serum amylase levels in peritoneal drainage fluid were found on the first day after operation. Serum albumin level was an independent risk factor for pancreatic fistula on the third day after operation. Conclusion: the levels of amylase and serum amylase in peritoneal drainage fluid on the first day after pancreaticoduodenectomy and serum albumin on the third day after pancreatoduodenectomy are important predictors of pancreatic fistula.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656

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