影响胰十二指肠切除术后早期并发症的危险因素分析

Risk factor analysis on early postoperative complications after pancreaticoduodenectomy

目的探讨影响胰十二指肠切除术后早期并发症的危险因素。方法对2005年3月至2010年10月行胰十二指肠切除术159例患者的临床资料进行回顾性分析；对影响术后早期并发症的相关因素进行分析。结果49例（30．8％，49／159）患者出现术后早期并发症。单因素分析表明，术前空腹血糖水平、总胆红素水平、白蛋白水平、高密度脂蛋白水平和术中出血量与胰十二指肠切除术后早期并发症发生显著相关（P〈0．05）；而性别、年龄、入院前黄疸、糖尿病病史、手术时间及是否门静脉重建与胰十二指肠切除术后早期并发症发生无明显相关性（P〉0．05）。多因素分析表明，术前空腹血糖水平（≥6．1mmol／L）、总胆红素水平（≥171umol／L）和白蛋白水平（〈35g／L）是胰十二指肠切除术后早期并发症发生的独立危险因素。结论充分认识影响胰十二指肠切除术后早期并发症发生的危险因素，加强这些危险因素的控制，以改善患者的早期预后。

Objective To investigate the risk factors of early postoperative complications after panereatieoduodenectomy. Methods The clinical data of 159 patients undergoing pancreaticoduodeneetomy from March 2005 to October 2010 was analyzed retrospectively. The related factors of early postoperative complications were analyzed. Results The incidence rate of early postoperative complications was 30.8% （49/159）. Univariate analysis showed that preoperative fasting blood glucose level, total serum bilirubin level, serum albumin level, high density lipoproteins level and intraoperative bleeding were closely correlated with early postoperative complications in patients undergoing pancreaticoduodenectomy （P 〈 0.05）, but gender, age, preoperative jaundice, history of diabetes mellitus, operation time and whether portal vein reconstruction were no significantly associated with early postoperative complications in patients undergoing pancreaticoduodenectomy （P 〉 0.05 ）. Multivariate analysis showed that preoperative fasting blood glucose level（ ≥6.1 mmol/L）, total serum bilirubin level （ ≥ 171 u mol/L） and serum albumin level（ 〈 35 g/L） were the important independent risk factors of early postoperative complications in patients undergoing pancreaticoduodenectomy. Conclusion The risk factors of panereaticoduodenectomy should be fully recognized and dealt with promptly.