胰十二指肠切除术后胃排空障碍相关危险因素分析

目的探讨胰十二指肠切除术后发生胃排空障碍的相关危险因素,为临床的防治提供参考。方法回顾性分析2005年1月至2013年7月间收治的120例胰头癌患者的临床资料,采用病例对照研究方法,将其中发生胃排空障碍的25例患者作为病例组,未发生胃排空障碍的95例患者作为对照组,对两组患者进行单因素分析和多因素非条件Logistic回归分析。结果单因素分析结果显示,手术后胰漏、手术方式、术后白蛋白水平、手术时间、术前总胆红素、术后血红蛋白、腹腔感染、术后输血量、术后空腹血糖、术后生长抑素例数及术前减黄与胰十二指肠切除术后胃排空障碍发生有关(P<0.05)。多因素非条件的Logistic回归分析显示,术后胰漏、手术方式、腹腔感染、术后空腹高血糖是胰十二指肠切除术后发生胃排空障碍的独立危险因素(P<0.05)。结论术后胰漏、手术方式、腹腔感染、术后空腹高血糖是胰十二指肠切除术后发生胃排空障碍的独立危险因素。

The related risk factors of delayed gastric emptying after pancreaticoduodenectomy

Objective To explore the related risk factors of delayed gastric emptying after pancre- aticoduodenectomy,to provides suggestions for clinical practice. Methods 120 pancreaticoduodenectomy patients were retrospective analyzed from January 2005 to July 2013, 25 patients with delayed gastric empty- ing were divided as case group, the remaining 95 patients were observed as control group, single factor anal- ysis and non-conditional logistic regression analysis was carried out for both groups. Results Single factor analysis results showed that postoperative pancreatic leakage, operation method, postoperative albumin bili- rubin, operation time, preoperative bilirubin postoperative hemoglobin, postoperative abdominal infection, postoperative blood transfusion volume, postoperative fasting glucose, somatostatin cases after operation and preoperative yellow reduction treatment had some relevance to delayed gastric emptying after pancreaticoduo- denectomy, the difference was statistically significant （ P 〈 0. 05 ） ; multivariate logistic regression showed that postoperative pancreatic leakage, operation method, abdominal cavity infection, postoperative hypergly- cemia were independent factors （ P 〈 0. 05 ）. Conclusion Postoperative pancreatic leakage, operation method, abdominal cavity infection, postoperative hyperglycemia are risk factors for delayed gastric empty- ing after pancreaticoduodenectomy.