胰十二指肠切除术前实验室检查与术后早期并发症相关性分析

Correlation analysis of the association between preoperative laboratory tests and early postoperative complication after pancreaticoduodenectomy

目的总结胰十二指肠切除术前实验室检查与术后早期并发症的相关性。方法回顾2008年1月至2009年12月间共410例行胰十二指肠切除术的临床病理资料,分析术后并发症的发生情况及其与术前实验室检查的相关性。结果本组术后早期并发症发生率为17.8%(73/410)。Logistic回归分析表明,手术前WBC升高(OR=1.1)、贫血(Hgb<110 g/L,OR=2.3;Hct<0.37,OR=1.5)、低白蛋白血症(OR=1.7)、BUN(OR=1.8)和Cr升高(OR=1.3)以及AKP正常(OR=0.7)均是术后早期发生并发症的重要危险因素。结论胰十二指肠切除术在胰腺病治疗中的并发症发生率已较以往下降,术前完善实验室检查可以帮助外科医生预判胰十二指肠切除术后发生早期并发症的危险因素,从而更好地进行手术风险评估。

Objective To investigate the correlation between preoperative laboratory tests and postoperative complications after pancreaticoduodenectomy.Methods Clinicopathological data of 410 patients underwent pancreaticoduodenectomy from Jan.2008 to Dec.2009 were collected to analyze the correlation between preoperative laboratory tests and postoperative complications after pancreaticoduodenectomy.Results The overall incidence of early postoperative complications was 17.8%（73/410）.Logistic regression analysis revealed that elevation of WBC（OR=1.1）,anaemia（Hgb110 g/L,OR=2.3;Hct0.37,OR=1.5）,hypoalbuminemia（OR=1.7）,elevation of BUN（OR=1.8） and Cr（OR=1.3）,normal AKP（OR=0.7） before operation were important risk fac-tors for early complications.Conclusion The postoperative complications after pancreaticoduodenectomy are lower than before.Routine preoperative biochemical tests can help surgeons to identify patients who are at increased risk for early postoperative complication after pancreaticoduodenectomy so that surgeons can evaluate the risks of operations better.