發(fā)布時(shí)間：2018-05-04 22:12

  本文選題：胰十二指腸切除手術(shù) + 胰瘺�。� 參考：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年10期

【摘要】：目的探討胰十二指腸切除手術(shù)(pancreaticoduodenectomy,PD)后早期拔除腹腔引流管能否減少術(shù)后胰瘺發(fā)生。方法回顧性分析西南醫(yī)院肝膽外科2013年1月至2015年10月收治并依據(jù)納入排除標(biāo)準(zhǔn)歸入研究對(duì)象的305例PD手術(shù)患者的臨床資料,按術(shù)后腹腔引流管拔除時(shí)間分為:A組,術(shù)后≤5 d拔除;B組,術(shù)后5 d拔除。比較兩組患者術(shù)后并發(fā)癥等發(fā)生情況,對(duì)胰瘺發(fā)生的相關(guān)因素進(jìn)行單因素和多因素分析。結(jié)果術(shù)后胰瘺(3.1%vs 12.1%)、腹腔感染(9.2%vs 20.3%)以及總并發(fā)癥(24.5%vs 42.0%)發(fā)生率A組均顯著低于B組(P0.05),術(shù)后住院時(shí)間也明顯縮短[13.0(4~44)d vs 15.5(9~64)d,P0.05]。單因素分析示:性別(P0.05)、術(shù)前有無(wú)顯性黃疸(P0.05)、胰管直徑(3 mm vs≥3 mm,P0.05)、腫瘤發(fā)生部位(胰腺vs胰腺外,P0.01)、腹腔引流管拔除時(shí)間(≤5 d vs5 d,P0.05)為術(shù)后胰瘺發(fā)生的影響因素;多因素Logistic回歸分析示:男性、胰管直徑3 mm、胰腺外腫瘤(膽總管遠(yuǎn)端、十二指腸乳頭部、膽胰壺腹部腫瘤)、腹腔引流管拔除時(shí)間5 d為胰瘺發(fā)生的獨(dú)立危險(xiǎn)因素(OR=4.424,2.369,3.874,5.028,P0.05)。結(jié)論對(duì)于PD術(shù)后早期無(wú)胰瘺發(fā)生的患者,術(shù)后5 d內(nèi)拔除腹腔引流管能夠顯著減少術(shù)后胰瘺、腹腔感染等并發(fā)癥,延長(zhǎng)腹腔引流管留置時(shí)間會(huì)增加術(shù)后胰瘺發(fā)生率。
[Abstract]:Objective to investigate whether the early extubation of abdominal drainage tube after pancreaticoduodenectomy can reduce the occurrence of pancreatic fistula after pancreaticoduodenectomy. Methods the clinical data of 305 PD patients treated in Southwest Hospital from January 2013 to October 2015 were analyzed retrospectively. The patients were divided into two groups according to the time of extubation of abdominal cavity drainage tube. Group B was removed at 鈮，

本文編號(hào)：1844891