胰十二指肠切除术后腹部并发症的危险因素分析

Risk factors for postoperative abdominal complications after pancreaticoduodenectomy

目的：分析胰十二指肠切除术后腹部并发症的危险因素。方法：回顾性分析我院1994年1月～2012年9月间160例胰十二指肠切除术病例，分析影响腹部并发症发生的危险因素。结果：160例患者中1例于手术当天因心源性休克死亡，予以除外，剩余159例腹部并发症的发生率为49．1％（78／159）。单变量分析结果表明，性别、胰腺质地、术中出血量、术中输血量、术后白蛋白是腹部并发症发生的危险因素（P〈0．01，P〈0．05）；多因素Logistic回归分析结果表明．术后白蛋白、术中出血量、胰腺质地是腹部并发症发生的独立危险因素（P〈0．01，P〈0．05）。结论：术后白蛋白低、术中出血量大、胰腺质地软是胰十二指肠切除术后腹部并发症发生的独立危险因素，积极控制危险因素可降低腹部并发症发生率。

Objective：To study the risk factors for postoperative abdominal complications of pancreaticoduodenectomy （PD）.Methods：The clinical data of 160 cases undergoing PD in the hospital from January 1994 to September 2012 were reviewed retrospectively.The risk factors for abdominal complications were analyzed.Results：One patient died of cardiac shock on the day of operation immediately,which was excluded.At last the left 159 data was analyzed.The incidence of postoperative abdominal complications was 49.1%（78/159）.Univariate analysis showed that sex,pancreatic texture,intraoperative hemorrhage,intraoperative transfusion,postop- erative serum albumin were the risk factors for postoperative abdominal complications of PD （P〈0.01 ,P〈0.05）. Multivariate Logistic analysis regression revealed that postoperative serum albumin,intraoperative hemorrhage, pancreatic texture were independent risk factors for postoperative main postoperative abdominal complications of PD （P〈0.01,P〈0.05）.Conclusion ： Low postoperative serum albumin,intraoperative hemorrhage, soft pancreas are independent risk factors for postoperative abdominal complications of PD.Controlling these risk factors can effectively decrease the incidence of postoperative abdominal complications of PD.