专题研究(Monographic Study)

远端胰腺切除术后胰瘘发生的危险因素分析

Published at: 2017年第26卷第3期

樊胜明 1 , 沈国新 1 , 胡金灵 1 , 刘君义 1
1 浙江省安吉县人民医院 外二科,浙江 安吉 313300
通讯作者 胜明 樊 Email: 2607510637@qq.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2017.03.004
基金:

摘要

目的:探讨影响远端胰腺切除术后胰瘘发生的相关性因素。方法:回顾2010年2月—2016年5月所实施的100例远端胰腺切除术患者临床资料,对相关因素进行单因素与多因素分析。结果:100例患者中32例(32%)发生术后胰瘘,包括A级胰瘘(无临床意义)18例(18%),有临床意义的胰瘘14例(14%),其中B级胰瘘8例,C级胰瘘6例。单因素分析中,高体质量指数(≥25 kg/m2)与术后胰瘘发生有关(χ2=4.128,P=0.042),但与有临床意义的胰瘘发生无关(χ2=1.545,P=0.214),软胰腺质地与胰瘘及有临床意义的胰瘘发生均明显有关(χ2=4.569,P=0.033;χ2=11.374,P=0.001)。多因素分析中软胰腺质地是胰瘘及有临床意义的胰瘘发生的唯一独立危险因素(OR=2.476,P=0.043;OR=8.012,P=0.003)。结论:胰腺质地是远端胰腺切除术后胰瘘发生的重要影响因素,对于胰腺质地软者,应采取积极防治措施。


Analysis of risk factors for pancreatic fistula after distal pancreatectomy

Abstract

Objective: To identify the factors associated with the occurrence of pancreatic fistula after distal pancreatectomy. Methods: The clinical data of 100 patients who underwent distal pancreatectomy from February 2010 to May 2016 were reviewed. The relevant factors were analyzed by univariate and multivariate analyses. Results: Among the 100 patients, postoperative pancreatic fistula occurred in 32 cases (32%), with grade A pancreatic fistula (without clinical impact) in 18 cases (18%), and clinically significant pancreatic fistula in 14 cases (14%), compromising grade B pancreatic fistula in 8 cases and grade C pancreatic fistula in 6 cases. In univariate analysis, the high body mass index (≥25 kg/m2) was significantly associated with the occurrence of overall postoperative pancreatic fistula (χ2=4.128, P=0.042), but not with the occurrence of clinically significant postoperative pancreatic fistula (χ2=1.545, P=0.214), while soft pancreatic texture was significantly associated with the occurrence of both overall and clinically significant postoperative pancreatic fistula (χ2=4.569, P=0.033; χ2=11.374, P=0.001). Multivariate analysis showed that soft pancreatic texture was unique independent risk for the occurrence of overall or clinically significant postoperative pancreatic fistula (OR=2.476, P=0.043; OR=8.012, P=0.003). Conclusion: Pancreatic texture is an important influential factor for the occurrence of postoperative pancreatic fistula, and aggressive control measures should be adopted in those with soft pancreatic texture.


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引用

引用本文: 胜明 樊, 国新 沈, 金灵 胡, 君义 刘. 远端胰腺切除术后胰瘘发生的危险因素分析[J]. 中国普通外科杂志, 2017, 26(3): 289-293.
Cite this article as: FAN Shengming, SHEN Guoxin, HU Jinling, LIU Junyi . Analysis of risk factors for pancreatic fistula after distal pancreatectomy [J]. Chin J Gen Surg, 2017, 26(3): 289-293.