Laparoscopic spleen-preserving total pancreatectomy for the treatment of low-grade malignant pancreatic tumors:Two case reports and review of literature

BACKGROUND Function-preserving pancreatectomy can improve the long-term quality of life of patients with benign or low-grade malignant tumors,such as intraductal papillary mucinous neoplasms(IPMNs)and mucinous cystic neoplasms.However,there is limited literature on laparoscopic spleen-preserving total pancreatectomy(LSpTP)due to technical difficulties.CASE SUMMARY Patient 1 was a 51-year-old male diagnosed with IPMN based on preoperative imaging,showing solid nodules in the pancreatic head and diffuse dilation of the main pancreatic duct with atrophy of the distal pancreas.We performed L-SpTP with preservation of the splenic vessels,and the postoperative pathology report revealed IPMN with invasive carcinoma.Patient 2 was a 60-year-old male with multiple cystic lesions in the pancreatic head and body.L-SpTP was performed,and intraoperatively,the splenic vein was injured and required ligation.Postoperative pathology revealed a mucinous cystic tumor of the pancreas with low-grade dysplasia.Both patients were discharged on postoperative day 7,and there were no major complications during the perioperative period.CONCLUSION We believe that L-SpTP is a safe and feasible treatment for low-grade malignant pancreatic tumors,but more case studies are needed to evaluate its safety,efficacy,and long-term outcomes.

Total pancreatectomy and islet autotransplantation: A decade nationwide analysis

AIM: To investigate outcomes and predictors of inhospital morbidity and mortality after total pancreatectomy(TP) and islet autotransplantation. METHODS: The nationwide inpatient sample(NIS) database was used to identify patients who underwent TP and islet autotransplantation(IAT) between 2002-2012 in the United States. Variables of interest were inherent variables of NIS database which included demographic data(age, sex, and race), comorbidities(such as diabetes mellitus, hypertension, and deficiency anemia), and admission type(elective vs nonelective). The primary endpoints were mortality and postoperative complications according to the ICD-9 diagnosis codes which were reported as the second to 25 th diagnosis of patients in the database. Risk adjusted analysis was performed to investigate morbidity predictors. Multivariate regression analysis was used to identify predictors of in-hospital morbidity.RESULTS: We evaluated a total of 923 patients who underwent IAT after pancreatectomy during 2002-2012. Among them, there were 754 patients who had TP + IAT. The most common indication ofsurgery was chronic pancreatitis(86%) followed by acute pancreatitis(12%). The number of patients undergoing TP + IAT annually significantly increased during the 11 years of study from 53 cases in 2002 to 155 cases in 2012. Overall mortality and morbidity of patients were 0% and 57.8 %, respectively. Postsurgical hypoinsulinemia was reported in 42.3% of patients, indicating that 57.7% of patients were insulin independent during hospitalization. Predictors of inhospital morbidity were obesity [adjusted odds ratio(AOR): 3.02, P = 0.01], fluid and electrolyte disorders(AOR: 2.71, P < 0.01), alcohol abuse(AOR: 2.63, P < 0.01), and weight loss(AOR: 2.43, P < 0.01). CONCLUSION: TP + IAT is a safe procedure with no mortality, acceptable morbidity, and achieved high rate of early insulin independence. Obesity is the most significant predictor of in-hospital morbidity.

Total pancreatectomy: Short- and long-term outcomes at a high-volume pancreas center

AIM To identify the current indications and outcomes of total pancreatectomy at a high-volume center. METHODS A single institutional retrospective study of patients undergoing total pancreatectomy from 1995 to 2014 was performed.RESULTS One hundred and three patients underwent totalpancreatectomy for indications including: Pancreatic ductal adenocarcinoma(n = 42, 40.8%), intraductal papillary mucinous neoplasms(n = 40, 38.8%), chronic pancreatitis(n = 8, 7.8%), pancreatic neuroendocrine tumors(n = 7, 6.8%), and miscellaneous(n = 6, 5.8%). The mean age was 66.2 years, and 59(57.3%) were female. Twenty-four patients(23.3%) underwent a laparoscopic total pancreatectomy. Splenic preservation and portal vein resection and reconstruction were performed in 24(23.3%) and 18 patients(17.5%), respectively. The 90 d major complications, readmission, and mortality rates were 32%, 17.5%, and 6.8% respectively. The 1-, 3-, 5-, and 7-year survival for patients with benign indications were 84%, 82%, 79.5%, and 75.9%, and for malignant indications were 64%, 40.4%, 34.7% and 30.9%, respectively.CONCLUSION Total pancreatectomy, including laparoscopic total pancreatectomy, appears to be an appropriate option for selected patients when treated at a high-volume pancreatic center and through a multispecialty approach.

Role of total pancreatectomy in the treatment of paraduodenal pancreatitis:A case report

BACKGROUND Paraduodenal pancreatitis(PP)is a rare form of chronic pancreatitis presenting with symptoms of duodenal obstruction.Conservative treatment is often unsuccessful and pancreaticoduodenectomy is the preferred surgical approach.A mini review of the outcomes of surgical therapy for PP shows that the results of pancreaticoduodenectomy are predominantly favorable.CASE SUMMARY In our case report of PP,we describe an unusual course first presenting with the symptoms of chronic pancreatitis and a pseudocyst of the pancreatic tail.A pseudocystojejunostomy was performed and the late postoperative course was complicated with the symptoms of duodenal obstruction.At laparotomy,PP was found and the patient was treated with a total pancreatectomy.The postoperative course was uneventful and good weight gain with resolution of pain was demonstrated at follow up visits.CONCLUSION Surgery is currently the optimal treatment option for PP.It is also the best diagnostic tool in distinguishing between pancreatitis and pancreatic adenocarcinoma.

Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy

AIM To evaluate the impact of glycemic control and nutritional status after total pancreatectomy(TP) on complications, tumor recurrence and overall survival.METHODS Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified.RESULTS High early postoperative fasting blood glucose(FBG) levels(OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels(OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative Hb A1 c levels over 7%(HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative Hb A1 c levels over 7% had much poorer overall survival than those with Hb A1 c levels less than 7%(9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus(HR = 15.019, 95%CI: 1.278-176.211, P= 0.031) and alcohol history(B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively.CONCLUSION At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on longterm outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

Partial pancreatic tail preserving subtotal pancreatectomy forpancreatic cancer: Improving glycemic control and quality of lifewithout compromising oncological outcomes

BACKGROUND Total pancreatectomy (TP) is usually considered a therapeutic option forpancreatic cancer in which Whipple surgery and distal pancreatectomy areundesirable, but brittle diabetes and poor quality of life (QoL) remain majorconcerns. A subset of patients who underwent TP even died due to severehypoglycemia. For pancreatic cancer involving the pancreatic head and proximalbody but without invasion to the pancreatic tail, we performed partial pancreatictail preserving subtotal pancreatectomy (PPTP-SP) in selected patients, in order toimprove postoperative glycemic control and QoL without compromisingoncological outcomes.AIM To evaluate the efficacy of PPTP-SP for patients with pancreatic cancer.METHODS We retrospectively reviewed 56 patients with pancreatic ductal adenocarcinomawho underwent PPTP-SP (n = 18) or TP (n = 38) at our institution from May 2014to January 2019. Clinical outcomes were compared between the two groups, withan emphasis on oncological outcomes, postoperative glycemic control, and QoL.QoL was evaluated using the European Organization for Research and Treatmentof Cancer Quality of Life Questionnaire (EORTC QLQ-C30 and EORTC PAN26).All patients were followed until May 2019 or until death.RESULTS A total of 56 consecutive patients were enrolled in this study. Perioperativeoutcomes, recurrence-free survival, and overall survival were comparablebetween the two groups. No patients in the PPTP-SP group developed cancerrecurrence in the pancreatic tail stump or splenic hilum, or a clinical pancreaticfistula. Patients who underwent PPTP-SP had significantly better glycemiccontrol, based on their higher rate of insulin-independence (P = 0.014), lowerhemoglobin A1c (HbA1c) level (P = 0.046), lower daily insulin dosage (P < 0.001),and less frequent hypoglycemic episodes (P < 0.001). Global health was similar inthe two groups, but patients who underwent PPTP-SP had better functional status(P = 0.036), milder symptoms (P = 0.013), less severe diet restriction (P = 0.011),and higher confidence regarding future life (P = 0.035).CONCLUSION For pancreatic cancer involving the pancreatic head and proximal body, PPTP-SPachieves perioperative and oncological outcomes comparable to TP in selectedpatients while significantly improving long-term glycemic control and QoL.

Total pancreatectomy with islet cell transplantation vs intrathecal narcotic pump infusion for pain control in chronic pancreatitis

AIM: To evaluate pain control in chronic pancreatitis patients who underwent total pancreatectomy with islet cell transplantation or intrathecal narcotic pump infusion.METHODS: We recognized 13 patients who underwent intrathecal narcotic pump(ITNP) infusion and 57 patients who underwent total pancreatectomy with autologous islet cell transplantation(TP + ICT) for chronic pancreatitis(CP) pain control between 1998 and 2008 at Indiana University Hospital. All patients had already failed multiple other modalities for pain control and the decision to proceed with either intervention was made at the discretion of the patients and their treating physicians. All patients were evaluated retrospectively using a questionnaire inquiring about their pain control(using a 0-10 pain scale), daily narcotic dose usage, and hospital admission days for pain control before each intervention and during their last follow-up. RESULTS: All 13 ITNP patients and 30 available TP + ICT patients were evaluated. The mean age was approximately 40 years in both groups. The median duration of pain before intervention was 6 years and 7 years in the ITNP and TP + ICT groups, respectively. The median pain score dropped from 8 to 2.5(on a scale of 0-10) in both groups on their last follow up. The median daily dose of narcotics also decreased from 393 mg equivalent of morphine sulfate to 8 mg in the ITNP group and from 300 mg to 40 mg in the TP + ICT group. No patient had diabetes mellitus(DM) before either procedure whereas 85% of those who underwent pancreatectomy were insulin dependent on their last evaluation despite ICT. CONCLUSION: ITNP and TP + ICT are comparable for pain control in patients with CP however with high incidence of DM among those who underwent TP + ICT. Prospective comparative studies and longer follow up are needed to better define treatment outcomes.

Total pancreatectomy for metachronous mixed acinar-ductal carcinoma in a remnant pancreas

In October 2009, a 71-year-old female was diagnosed with a cystic tumor in the tail of the pancreas with an irregular dilatation of the main pancreatic duct in the body and tail of the pancreas. A distal pancreatectomy with splenectomy, and partial resection of the duodenum, jejunum and transverse colon was performed. In March 2011, a follow-up computed tomography scan showed a low density mass at the head of the remnant pancreas. We diagnosed it as a recurrence of the tumor and performed a total pancreatectomy for the remnant pancreas. In the histological evaluation of the resected specimen of the distal pancreas, the neoplastic cells formed an acinar and papillary structure that extended into the main pancreatic duct.Mucin5AC, α1-antitrypsin(α-AT) and carcinoembryonic antigen(CEA) were detected in the tumor cells by immunohistochemistry. In the resected head of the pancreas, the tumor was composed of both acinar and ductal elements with a mottled pattern. The proportions of each element were approximately 40% and 60%, respectively. Strongly positive α-AT cells were detected in the acinar element. Some tumor cells were also CEA positive. However, the staining for synaptophysin and chromogranin A was negative in the tumor cells. Ultimately, we diagnosed the tumor as a recurrence of mixed acinar-ductal carcinoma in the remnant pancreas. In conclusion, we report here a rare case of repeated pancreatic resection for multicentric lesions of mixed acinar-ductal carcinoma of the pancreas.

早期目标导向活动方案对胰腺肿瘤切除术后患者活动的影响

目的:分析早期目标导向活动方案在胰腺肿瘤切除术后患者中的临床应用效果,以期提高患者术后早期活动的有效性及主动性,促进患者术后康复。方法:随机选取2023年3月—5月在上海市某三级甲等医院完成胰腺手术的35名患者为对照组,2023年6月—8月的35名患者为实验组。对照组采取胰腺肿瘤切除术后常规护理措施,实验组除采取常规护理,在督促患者早期下床活动方面应用早期目标导向活动方案。对比两组患者术后首次下床、肛门排气、排便、经口饮水、导尿管拔除及胃管拔除时间来评价方案有效性;对比两组患者术后并发症及活动相关不良事件发生情况来评价方案安全性。结果:两组患者首次下床、肛门排气、排便、经口饮水时间差异有统计学意义(P<0.05),导尿管拔除、胃管拔除时间及术后并发症发生情况差异无统计学意义(P>0.05),两组患者均未发生活动相关不良事件。结论:早期目标导向活动方案对促进胰腺肿瘤切除术后患者早下床、早经口饮水、术后排气和排便方面是安全、有效的,且不增加术后出血、非计划拔管、死亡等风险。

浅水湖泊TP分布的迎风有限元数值模型研究

从控制方程出发，以Ｇａｌｅｒｋｉｎ有限元法为基础，结合有限元法的较新改进，推导、建立了一个适合于浅水湖泊ＴＰ浓度分布计算的二维迎风有限元的数值模型，并将其应用于太湖。

Quality of life after pancreatic surgery

BACKGROUND Pancreatic surgery is challenging owing to the anatomical characteristics of the pancreas.Increasing attention has been paid to changes in quality of life(QOL)after pancreatic surgery.AIM To summarize and analyze current research results on QOL after pancreatic surgery.METHODS A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Relevant studies were identified by screening the references of retrieved articles.Studies on patients’QOL after pancreatic surgery published after January 1,2012,were included.These included prospective and retrospective studies on patients'QOL after several types of pancreatic surgeries.The results of these primary studies were summarized inductively.RESULTS A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more accurate.Although TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after TP.The QOL was better after DPPHR than PD.However,the superiority of the QOL between patients who underwent CP and PD remains controversial.The decrease in exocrine and endocrine functions postoperatively was the main factor affecting the QOL.Minimally invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic surgery.The article covers the discussion and analysis of the QOL of various pancreatic surgeries.Which kind of surgical procedure has better QOL is controversial.The long-term benefits on QOL of minimally invasive surgery over open surgery are contro-INTRODUCTION The pancreas,located in the retroperitoneum,is a glandular organ with endocrine and exocrine functions.It can be divided into four main parts:Head,neck,body,and tail.Pancreatic surgery can be divided into pancreaticoduoden-ectomy(PD),duodenum-preserving pancreatic head resection(DPPHR),distal pancreatectomy(DP),central pancre-atectomy(CP),and total pancreatectomy(TP).Pancreatic surgery is challenging due to the organ’s complex anatomical structure,peripheral vascularity,and intractable postoperative complications.Following the standardization of surgical steps and improvements in relevant medical techniques and surgical instruments,the safety of pancreatic surgery has significantly improved.Perioperative morbidity,mortality,and other related indicators have become more acceptable.However,owing to the organ’s essential role in digestion,absorption,and blood glucose regulation,changes in the quality of life(QOL)of patients after pancreatic surgery have attracted the attention of surgeons.More patients with non-malignant pancreatic diseases are willing to undergo surgical treatment because of the acceptable safety.In this case,from the perspective of the patient postoperatively,the significance of rehabilitation reflects the traditional perioperative outcome and QOL[1].The QOL is a new concept that extends beyond health.Although there is no consensus on its conception[2],we can consider it a multi-dimensional architecture that incorporates objective and individual subjective views of aspects of one’s physical,psychological,and social well-being[3-5].It includes evaluating physical health,and many subscales,such as emotion,job,culture,family,sociability,economy,cognition,happiness,sex,and some symptoms[6].Since people have realized the importance of QOL,many QOL scales have emerged,including the European Organization for Research and Treatment of Cancer QLQ-C30,European Quality of Life 5-dimension,36-item Short,etc.However,it is challenging to follow up on patients’QOL once they are discharged from the hospital.Consequently,most relevant studies had small sample sizes or lacked long-term follow-up results.Moreover,a summary of studies on QOL after pancreatic surgery is lacking.This study assessed the QOL in patients who underwent PD,DPPHR,DP,CP and TP.We conducted this study to describe the existing findings on the QOL after pancreatic surgery to make it easier for surgeons and patients to decide on a surgical approach.In addition,we attempted to identify controversial results to encourage further targeted research.

LAS对人工快滤系统去除TP的影响

文章运用人工土柱模拟的方法来研究LAS对人工快滤系统去除TP的影响。研究结果表明,随着污水中LAS浓度(≤100mg/L)的增加,人工快滤系统对TP的去除率表现为逐渐下降。TP的去除率大小为处理Ⅰ>处理Ⅱ>处理Ⅲ>处理Ⅳ。在延长干化时间条件下,TP的去除率增大,并且LAS浓度越大效果越明显。LAS对人工快滤系统中TP的去除有着显著的影响;但合理地控制工艺参数能够实现LAS和TP的有效去除。

TPS based on trilateration for the feed measurement of FAST

Five-hundred-meter Aperture Spherical radio Telescope( FAST) is the largest sensitive single dish radio telescope in the world,in which the control and measurement of the feed is one crucial section of the FAST control system. Trilateration is presented to obtain three-dimensional coordinate for tracking feed focus cabin. Every three total stations chase prism movement to be attached on feed focus cabin and the prism position is determined from the measured distances based on the principle of trilateration. Therefore,feed position is determined from three prisms on the focus cabin. This study is to assess the accuracy and reliability of trilateration calculation on tracking focus cabin of FAST. Different arrangement of total stations on trilateration is theoretically studied. Through experiment,the proposed method shows that the accuracy is better than that of the polar coordinate measurement. The average root mean square error is lower than 0. 6 mm,which is found to have high accuracy and reliability.

冠状动脉侧支循环及PCI治疗对CTO患者Tp-e间期、Tp-e/QT比值的影响

目的探讨冠状动脉侧支循环(coronary collateral circulation,CCC)对冠状动脉慢性完全闭塞病变(chronic total coronary occlusion,CTO)患者Tp-e间期、Tp-e/QT比值的影响,以及经皮冠状动脉介入(percutane⁃ous coronary intervention,PCI)治疗对CTO患者Tp-e间期、Tp-e/QT比值的影响及临床意义。方法本研究选取邵阳市中心医院心内科2018年7月至2020年12月期间CTO患者共150例。CCC采用Rentrop评分进行分级,将入选患者分为CCC不良组(Rentrop 0级、1级组),CCC良好组(Rentrop 2级、3级组)。测量各组患者心电图中Tp-e间期、Tp-e/QT比值。另从以上研究对象中按是否成功行PCI治疗分为PCI治疗成功组及PCI治疗失败组。观察两组患者PCI治疗前及治疗后心电图中Tp-e间期、Tp-e/QT比值的情况。结果CCC良好组患者Tp-e间期、Tp-e/QT比值低于CCC不良组,差异有统计学意义(P<0.05)。PCI治疗成功组与PCI治疗失败组患者术前临床资料及Tp-e间期、Tp-e/QT比值比较,差异有统计学意义(P<0.05)。PCI治疗成功组患者术后Tp-e间期、Tp-e/QT比值较术前下降,差异有统计学意义(P<0.05)。PCI治疗成功组患者术后Tp-e间期、Tp-e/QT比值低于PCI治疗失败组,差异有统计学意义(P<0.05)。结论CTO患者中,良好的侧支循环形成有利于降低心室跨壁复极离散度指标Tp-e间期、Tp-e/QT比值,更好地恢复CTO患者心肌细胞电生理稳定性;成功的PCI治疗可以减少CTO患者心室复极离散度指标Tp-e间期、Tp-e/QT比值,从而降低室性心律失常发生的风险。

Measuring Quality of Economic Growth Incorporating Environment and Social Welfare:a Total Productivity Approach with an Application on China

By extending the traditional productivity theory,a new concept total productivity( TP) is introduced. Using a directional distance function approach,the concept is applied to measuring economic growth of 8 economic regions of China covering an 18 years period( 1997—2014) and test its convergence. Results showed that TP grew at an average rate of 6. 6% per year led mainly by technical change( 6. 5%). When environmental undesirable outputs are included,the Middle Yellow River,Northwest and Southwest regions of China witnessed higher productivity changes. Results of the convergence analysis revealed that China had made progress in reducing regional imbalance in growth. Inclusion of undesirable output showed that the energy-saving emission reduction policies had speed up the convergence rate of TP and environment oriented productivity. However,China's welfare oriented productivity is still very low.

TPS控制系统在三聚氰胺装置的使用要领及安全策略

介绍了高压法工艺生产三聚氰胺装置的DCS集散控制系统基本结构和TPS系统的特点、构成、配置;分析了TPS系统网络接口模件在生产中出现的问题;提出了TPS系统单个软件安装时系统的安全策略。

鄱阳湖水位对沉积物磷释放的影响及总磷考核建议

为探讨干湿交替对湖泊沉积物内源磷释放的影响,结合基础资料和模拟试验,研究了鄱阳湖水位波动及其驱动下沉积物中磷的释放过程,并对湖区总磷(TP)考核提出建议。结果表明:2020~2022年鄱阳湖星子站水位高幅波动,最高水位差分别为15.01,11.42 m和12.69 m,导致水面面积也呈现高度动态性,最低水位时的裸露面积分别达到3433.92,3442.40 km^(2)和3618.36 km^(2),大面积沉积物会经历干湿交替过程;沉积物磷释放模拟试验结果显示,南矶山和青岚湖断面沉积物经历裸露-暴晒-淹水后,淹水初期沉积物TP的平均释放通量分别高达16.67 mg/(m^(2)·d)和13.23 mg/(m^(2)·d);综合考虑鄱阳湖水体中TP组成特征和水位波动的影响,建议湖区国控断面以活性磷酸盐(SRP)或者溶解性总磷(TDP)替代TP作为磷考核指标,并动态调整磷考核标准的阈值,当星子站水位低于11.00 m时以河流标准考核。

抚仙湖水体总磷(TP)周年变化及水质影响评价

为研究抚仙湖水体总磷(TP)的周年变化,进一步了解水质状况,分析了2018年5月(春季)、8月(夏季)、11月(秋季)、2019年2月(冬季)水体总磷(TP)和部分理化指标的监测数据,采用综合指数法(TLI(∑))进行水质营养状态评价,并分析其变化趋势。结果表明,总磷(TP)是影响抚仙湖水质营养状态变化的主要指标,综合营养指数(TLI(∑))年均值小于30。评价认为,抚仙湖水质处于贫营养状态。

基于水体溯源的澜沧江梯级水库水体总磷来源及滞留效应分析

梯级水库建设对澜沧江流域生源物质迁移过程的影响受到国内外学者广泛关注。研究利用稳定同位素技术,于枯水期(2017年2月)、丰水期(2017年6月)分别测定了小湾、漫湾、糯扎渡、景洪四个水库不同来源水体(上一级水库下泄水量、支流汇入、坡面径流、人工水循环)总磷(TP)浓度及水库水体氢氧同位素值(18O、D),基于多元线性混合模型,分析了不同来源水体水量的贡献率,并计算了澜沧江流域梯级水库TP滞留量。结果表明:上一级水库下泄水量对水库TP来源及滞留效应的贡献率在丰水期及枯水期均占主要部分,贡献率分别为54.8%~79.3%、39.1%~82.8%,从上游到下游呈沿程增加趋势;人工水循环水量在枯水期呈沿程增加趋势;坡面径流水量在丰水期呈沿程增加趋势。TP滞留率在枯水期和丰水期分别为-49.34%~66.72%、-88.79%~88.40%,丰水期滞留率受水量增加影响较大,枯水期则受人类活动及沿程输入影响较大。研究为对有针对性地控制流域TP滞留量及为下游水生态环境质量评价提供数据支撑。