胰十二指肠切除术后并发症.docVIP

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胰十二指肠切除术后并发症

胰十二指肠切除术后并发症相关因素分析 张凯1。2 宋振顺1 1.第四军医大学西京医院;2.解放军第323医院(陕西省西安市 710032)ML,年龄>60 岁,术前血红蛋白100g/L.结论 术前血清总胆红素>171 μmol/L,术前血清白蛋白30g/L 和 术中出血量>800 ML是胰十二指肠切除术术后并发症的高危因素,其次的危险因素为年龄>60 岁、术前血红蛋白100g/L。手术者应掌握好手术时机,加强围手术期处理,从而降低胰十二指肠切除术术后并发症。 关键词:胰十二指肠切除术;危险因素;Logistic回归分析 中图分类号:R-657 R657.5 文献标识码:A Risk factors of complications after pancreatieoduodenectomy ZHANG Kai1,2,-shun1,(1.Department of hepatobiliary surgery, Xijing hospital, Fourth Military Medical University, 17 West Changle Road, Xi’an, Shaanxi, 710032, PR China;; 2. No.323 Hospital of PLA, Xi’an, Shaanxi, 710054, PR China)postoperative complications after pancreaticoduodenectomy and their relationships with clinical risk factors。Methods The clinical data from 258 patients undergoing PD in Xijing Hospital from 2000 to 2009 was collected and the clinical risk factors of postoperative complications was investigated by Univariate and multivariate analysis. Results The postoperative complication rate was 22.1% (57/258)。The general complications include pancreatic or biliary anastomotic leakage ,abdominal infection and bleeding. Logistic regression analysis revealed that the clinical risk factors of postoperative complication including: preoperative total serum bilirubin level over 171 μmol/L, preoperative albumin less than 30g/L ,blood-loss of during operate over 800 ml, age over 60 years, preoperative Hb less than 100g/L. Conclusions preoperative total serum bilirubin level over 171 μmol/L, preoperative albumin less than 30g/L and blood-loss of surgery over 800 ml are the high risk factors of the postoperative complications of PD. over 60 years, preoperative Hb less than 100g/L are the minor risk factors of the postoperative complications of PD. The surgeon should predominate operative opportunity and enhanced perioperative management in order to reducing postoperative complications after PD. Key words:Panereaticoduodenectomy;Riskfactors;Logistic regression analysis Chinese

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