胰头十二指肠切除术后迟发性出血相关因素分析

Clinical analysis of related risk factors for delayed hemorrhage after pancreaticoduodenectomy

目的:探讨胰头十二指肠切除术(PD)术后迟发性出血发生的相关危险因素。方法:回顾性分析2012年1月—2015年6月511例行PD患者的临床资料。结果:PD术后迟发性出血发生率8.81%(45/511)。单变量分析表明:术前胆红素水平、胰瘘、胆瘘、术后腹腔感染为有意义的相关因素(P<0.05)。应用Logistic回归多变量分析,胰瘘(OR=2.158)、术后腹腔感染(OR=3.051)是迟发性出血的独立危险因素(P<0.05)。结论:对PD术后胰瘘、腹腔感染等并发症做到及早发现、迅速诊断、正确处理可有效减少迟发性出血发生率。

Objective： To invest the risk factors associated with delayed hemorrhage after pancreaticoduodenectomy occurred. Methods： A retrospective analysis was performed from Jan- uary 2012 to June 2015 Shengjing hospital 511 cases of patients who accepted pancreaticoduo- denectomy. Results： The incidence of PD postoperative delayed hemorrhage was 8.81% （45/511）. Univariate analysis shows： Preoperative bilirubin levels, pancreatic fistula, biliary fistula, postoperative abdominal infection are all the meaningful related factors（P〈0.05）. With the application of multivariate logistic regression analysis, pancreatic fistuJa （OR=2.158） and abdominal infection （OR=3.051） were in- dependent risk factors for postoperative delayed hemorrhages （P〈0.05）. Conclusion： Dealing with the postoperative complications of PD like pancreatic fistula, abdominal infection and others, early detection and rapid diagnosis and correct treatment can effectively reduce the incidence of delayed hemorrhage.