胰肠吻合口瘘的危险因素临床对照研究

Analysis of the Risk Factors of Intestinal Anastomotic Fistula of Pancreas

目的分析胰十二指肠切除术后胰肠吻合口瘘发生的危险因素。方法选取2009年1月至2012年1月在新疆医科大学第一附属医院行胰十二指肠切除术治疗的92例患者作为研究对象,分析胰肠吻合口瘘患者与未发生胰肠吻合口瘘患者的一般资料。结果胰肠吻合口瘘的患者与未发生胰肠吻合口瘘的患者在年龄(>65岁)、术前黄疸、胰腺质地柔软、术前贫血、术前低蛋白血症、胰管直径(<3 mm)、放置引流、腹腔感染等方面差异有统计学意义(P<0.05);多因素回归分析显示,胰腺质地柔软、胰管直径<3 mm是胰十二指肠切除术后发生胰肠吻合口瘘的独立危险因素(P<0.05)。结论胰腺质地柔软和胰管直径是胰十二指肠切除术后胰肠吻合口瘘的主要危险因素,临床应重视对其防治,以有效降低胰肠吻合口瘘的发生。

Objective To analyze the risk factors of intestinal anastomotic fistula of pancreas after pancreaticoduodenectomy.Methods Total of 92 patients who underwent pancreaticoduodenectomy in the First Affiliated Hospital of Xinjiang Medical University from Jan.2009 to Jan.2012 were selected for this study,and the general parameters of the patients with and without pancreatic fistula were analyzed.Results The age（〉65 years）,preoperative jaundice,soft pancreas,preoperative anemia,preoperative hypoproteinemia,pancreiatic duct diameter（〈3 mm）,placement drainage,abdominal infection of the patients with and without pancreatic fistula were statistically significantly different （P 〈 0.05）.The multi-factor regression analysis revealed that the soft pancreas and pancreatic duct diameter 〈 3 mm were the independent risk factors of pancreatic fistula after pancreaticoduodenectomy（P 〈 0.05）.Conclusion Soft pancreas and pancreatic duct diameter were the independent risk factors of pancreatic fistula after pascreaticoduodenectomy,the prevention and treatment of which should be paid more attention in clinical,in order to reduce the incidence of intestinal anastomotic fistula of pancreas effectively.