本文選題：胰十二指腸切除術(shù) + 胰瘺　； 參考：《第三軍醫(yī)大學(xué)學(xué)報》2017年11期

【摘要】：目的探討胰十二指腸切除術(shù)(pancreatoduodenectomy,PD)后胰瘺的高危因素及術(shù)前胰腺體部擬切除斷面平掃期CT值(以下簡稱胰體部CT值)對PD術(shù)后胰瘺發(fā)生風(fēng)險的預(yù)測價值。方法回顧性分析西南醫(yī)院肝膽外科2013年1月至2015年12月期間收治的408例住院行胰十二指腸切除術(shù)患者的完整病歷資料,單因素分析采用Pearson卡方檢驗(yàn),多因素分析采用二分類Logistic回歸分析,胰體部CT值與胰瘺之間的相關(guān)性采用簡單線性相關(guān)分析,其對PD術(shù)后胰瘺的預(yù)測價值采用受試者工作特征(ROC)曲線下面積。結(jié)果 408例患者共發(fā)生胰瘺123例(30.14%),單因素分析顯示BMI、術(shù)前γ-谷氨酰轉(zhuǎn)肽酶、胰管直徑、胰體部CT值、手術(shù)時間、胰腺質(zhì)地軟硬(術(shù)中判斷)是PD術(shù)后胰瘺的危險因素;多因素分析顯示BMI≥25 kg/m~2、胰管直徑≤3 mm、胰體部CT值40 Hu、胰腺質(zhì)地軟(術(shù)中判斷)軟為PD術(shù)后胰瘺發(fā)生的獨(dú)立高危因素。不同胰瘺嚴(yán)重程度分級患者的胰體部CT值相比較,差異有統(tǒng)計學(xué)意義(P0.05)。胰瘺嚴(yán)重程度與胰體部CT值呈負(fù)相關(guān)。胰體部CT值ROC曲線下面積為0.714,對PD術(shù)后胰瘺具有中等預(yù)測價值。結(jié)論 BMI≥25 kg/m~2、胰管直徑≤3 mm、胰體部CT值40 Hu、胰腺質(zhì)地軟硬(術(shù)中判斷)軟為PD術(shù)后胰瘺發(fā)生的獨(dú)立高危因素,胰體部CT值對PD術(shù)后胰瘺具有中等預(yù)測價值,可指導(dǎo)圍手術(shù)期治療方案。
[Abstract]:Objective to investigate the high risk factors of pancreatic fistula after pancreatoduodenectomy (PDD) and to evaluate the value of preoperative CT value (CT value of pancreatic body) in predicting the risk of pancreatic fistula after PD. Methods the complete medical records of 408 inpatients undergoing pancreaticoduodenectomy in Southwest Hospital from January 2013 to December 2015 were retrospectively analyzed. Pearson chi-square test was used for univariate analysis. The correlation between CT value of pancreatic body and pancreatic fistula was analyzed by simple linear correlation analysis. The predictive value of pancreatic fistula after PD was determined by the area under the operating characteristic curve. Results there were 123 cases with pancreatic fistula in 408 cases. Univariate analysis showed that the risk factors of pancreatic fistula were preoperative 緯 -glutamyl transpeptidase, pancreatic duct diameter, CT value of pancreatic body, operation time, soft and hard pancreas texture (judging during operation). Multivariate analysis showed that BMI 鈮，

本文編號：1961392