摘要
目的分析营养风险指数(nutritional risk index,NRI)与胰十二指肠切除术后手术部位感染(surgical site infection,SSI)的关系,以探讨NRI在预测胰十二指肠切除术后SSI中的价值。方法回顾性收集南京大学医学院附属鼓楼医院胰腺外科2017年1月至2017年12月行胰十二指肠切除术的108例病人临床资料,根据是否出现SSI分为SSI(-)组和SSI(+)组,通过单因素分析评价SSI风险因素,通过多因素回归分析评价NRI在预测胰十二指肠切除术后SSI中的价值。结果本组36例病人出现SSI(33.3%),其中切口感染16例,腹腔感染28例,24例胰瘘(B或C级)。单因素分析显示:胰瘘、NRI、营养风险筛查2002(nutritional risk screening 2002,NRS-2002)与胰十二指肠切除术后SSI相关。多因素回归分析显示:胰瘘(P<0.001)、NRI(P=0.018)是胰十二指肠切除术后SSI的独立危险因素。术前胆道引流、NRI、NRS-2002与胰十二指肠切除术后非胰瘘病人SSI相关,NRI也是胰十二指肠切除术后非胰瘘病人SSI的独立危险因素(P=0.023)。结论 NRI是胰十二指肠切除术后SSI的独立危险因素,在预测SSI中有重要作用。
Objective To determine the relationship between preoperative nutritional screening scores and the development of surgical site infection(SSI)after pancreatoduodenectomy.Methods We examined 108 patients who had undergone pancreatoduodenectomy.Their clinical data,nutritional risk index(NRI),and nutritional risk screening 2002(NRS-2002)score were recorded.Univariate and multivariate analyses were conducted to identify risk factors for SSI.Results SSI developed in 36 patients(33.3%).Sixteen patients had wound infections,and 28 patients had an intra-abdominal abscess.A univariate analysis of pre-and intra-operative factors revealed that a pancreaticstula,the NRS-2002,and the NRI were significantly associated with the development of SSI(P〈0.05).The multivariate logistic regression analysis revealed that a pancreaticstula and the NRI were independent risk factors for SSI.By analyzing the pre-and intra-operative factors after excluding the 24 patients with pancreaticstula,the NRI was still an independent risk factor for SSI.Conclusions The present study showed the NRI to be an independent factor for predicting the risk of SSI after pancreatoduodenectomy.
作者
李刚
毛谅
仇毓东
Li Gang;Mao Liang;Qiu Yudong(Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)
出处
《腹部外科》
2018年第5期317-321,共5页
Journal of Abdominal Surgery