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目的:分析胰腺切除术后并发症的发生率,探讨胰腺切除术后常见并发症的临床因素及预防对策。方法:回顾性分析2008年12月到2009年6月间复旦大学附属华山医院142例胰腺切除手术后发生的常见并发症及其临床相关因素,采用Logistic回归法分析各因素与胰漏、胃排空延迟(delayed gastric emptying、DGE)、胰周感染发生的相关性。结果:本组病人围手术期并发症总的发生率为45.8%(65/142例),术前是否减黄与胰漏相关,前白蛋白、手术时间、术中出血量、输血量与术后DGE发生正相关(P=0.001、0.035、<0.001、<0.001)。体质量指数(body mass index,BMI)、术中出血量、输血量与胰周感染呈负相关(P=0.016、0.003、0.001)。Logistic回归分析发现术中出血量和输血量是DGE的危险因素,BMI和输血量是胰周感染的危险因素。结论:术前减黄能减少术后胰漏的发生,减少术中出血能降低DGE的发生,肥胖病人易发生胰周感染。
Objective: To analyze the incidence of complications after pancreatectomy and discuss the clinical factors and preventive measures of common complications after pancreatectomy. Methods: A retrospective analysis of 142 cases of Huashan Hospital Affiliated to Fudan University from December 2008 to June 2009 occurred after pancreatic resection and the common complications and clinical factors, using Logistic regression analysis of the factors and pancreatic leakage, gastric row Deletion of delayed gastric emptying (DGE), Peritival infection. Results: The overall incidence of perioperative complications in this group was 45.8% (65/142 cases). Preoperative reduction of yellowing correlated with pancreatic leakage, prealbuminuria, operation time, intraoperative blood loss, blood transfusion volume and operation After DGE positive correlation (P = 0.001,0.035, <0.001, <0.001). Body mass index (BMI), intraoperative blood loss and transfusion volume were negatively correlated with peripancreatic infection (P = 0.016, 0.003, 0.001). Logistic regression analysis found that intraoperative blood loss and blood transfusion were risk factors for DGE. BMI and blood transfusion were risk factors for peripancreatic infection. Conclusion: Preoperative reduction of yellow can reduce postoperative pancreatic leakage, reduce intraoperative bleeding can reduce the incidence of DGE, peritoneal infection prone to obesity in patients.