胰十二指肠切除术后胰痿相关因素的Meta分析

发布时间：2018-08-02 16:03

【摘要】：目的：回顾和总结胰十二指肠切除术后胰瘘的相关因素,为正确认识术后胰瘘的相关危险因素提供统计学依据,为临床提供理论依据。方法：采用PRISMA声明制定的Meta分析法检索2009年1月至2013年12月期间公开发表的关于胰十二指肠切除术后发生胰瘘的相关因素的文献。按照纳入和排除标准,共有14篇资料累计2332例病例纳入研究。运用RevMan 5.2软件进行数据提取和分析。结果：胰十二指肠切除术中胰胃吻合与胰肠吻合、标准胰十二指肠切除术与保留幽门胰十二指肠切除术术后胰瘘的发生率相当(P0.05)；手术时间、有无糖尿病与胰瘘的发生无明显相关(P0.05)。体重指数(BMI)大于等于25kg/m2术后胰瘘率明显增高(OR=3.52,95%CI:2.31-5.36,P0.05);主胰管直径大于等于3mm组胰瘘率明显小于直径小于3mm组(OR=0.24,95%CI:0.17-0.35,P0.05);胰腺质软组的胰瘘率明显高于质硬组(OR=6.03,95%CI:3.72-9.77,P0.05);术后病理诊断为胰腺癌组的胰瘘率明显低于非胰腺癌组(OR=0.32,95%CI:0.24-0.44,P0.05);胰瘘组的术中出血量多于无胰瘘组(P=0.004)。结论：胰十二指肠切除术中胰胃吻合与胰肠吻合、标准胰十二指肠切除术与保留幽门胰十二指肠切除术术后胰瘘的发生率相当；手术时间、有无糖尿病对术后胰瘘的发生无明显相关。体重指数、胰管直径、胰腺质地、壶腹癌及壶腹周围癌、术中出血量是胰十二指肠切除术后发生胰瘘的危险因素。
[Abstract]:Objective: to review and summarize the related factors of pancreatic fistula after pancreaticoduodenectomy, to provide statistical basis for correct understanding of the risk factors of pancreatic fistula after pancreaticoduodenectomy, and to provide theoretical basis for clinical practice. Methods: the Meta analysis developed by the PRISMA statement was used to search the literature published between January 2009 and December 2013 on the factors associated with pancreatic fistula after pancreatoduodenectomy. According to the inclusion and exclusion criteria, a total of 14 data of 2332 cases were included in the study. RevMan 5.2 software is used to extract and analyze the data. Results: during pancreaticoduodenectomy, pancreaticoduodenectomy was performed with pancreaticoduodenostomy. The incidence of pancreatic fistula after standard pancreaticoduodenectomy and pyloric pancreaticoduodenectomy was similar (P0.05). There was no significant correlation between diabetes mellitus and pancreatic fistula (P0.05). Body mass index (BMI) was significantly higher than that of 25kg/m2 group (OR 3.5295 CI: 2.31-5.36), the pancreatic fistula rate of the group with the diameter of the main pancreatic duct greater than that of the 3mm group was significantly smaller than that of the 3mm group (ORO 0.24 + 95 CI: 0.17-0.35 P0.05), the pancreatic fistula rate in the soft pancreas group was significantly higher than that in the hard group (OR6.0395% CI: 3.72-9.77 P0.05), and the postoperative pathological diagnosis was that the pancreatic fistula rate in the soft pancreas group was significantly higher than that in the hard group (OR 6.0395 CI: 3.72-9.7p0.05). The rate of pancreatic fistula in adenocarcinoma group was significantly lower than that in non-pancreatic cancer group (P 0.05), and the amount of intraoperative bleeding in pancreatic fistula group was higher than that in no pancreatic fistula group (P 0.004). Conclusion: during pancreaticoduodenectomy, pancreaticoduodenostomy and pancreaticoduodenostomy have the same incidence of pancreatic fistula after pancreaticoduodenectomy and pyloric pancreaticoduodenectomy. There was no significant correlation between diabetes mellitus and postoperative pancreatic fistula. Body mass index (BMI), pancreatic duct diameter, pancreatic texture, ampullary carcinoma and periampullary carcinoma were the risk factors for pancreatic fistula after pancreaticoduodenectomy.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.64

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