影响联合血管切除重建胰十二指肠切除术患者预后因素分析  

Factors influencing prognosis of patients undergoing pancreaticoduodenectomy combined with vascular resection and reconstruction

作　　者：弓毅[1] 张雷达[1] 丁钧[1] 张宏宇[1] 别平[1] 王槐志[1] 

机构地区：[1]第三军医大学西南医院肝胆外科全军肝胆外科研究所,重庆400038

出　　处：《中华普外科手术学杂志（电子版）》2013年第3期33-36,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金资助项目(81072439);全军十二五科技计划面上项目(CWS11J051);国家863项目(2012AA021105);卫生公益性行业科研专项经费项目(201202007)

摘　　要：目的针对行联合血管切除重建的胰十二指肠切除术后患者的生存率进行调查分析,探究胰腺癌患者行联合血管切除重建的胰十二指肠切除术后,影响其预后的主要因素。方法回顾性分析2006年1月至2011年12月97例行联合血管切除重建胰十二指肠切除术的胰腺癌患者临床及病理资料。将患者年龄、有无淋巴结转移、血管重建方式、有无术后并发症发生、肿瘤大小及肿瘤分化程度作为患者生存时间的影响因素进行分析。结果 97例联合血管切除胰十二指肠切除术的胰腺癌患者平均生存时间11.9个月,1、2、3年存活率分别为30.3%、14.1%、8.1%。联合血管切除患者术后30d内有8例患者死亡,病死率为8.2%(8/97);术后并发症发生率为20.6%(20/97),其中以腹腔内出血为主要术后并发症。肿瘤分化程度以及术后有无并发症发生是患者能否长期生存的独立影响因素。结论影响患者术后生存时间的两个独立因素分别是肿瘤分化程度以及术后有无并发症发生。减少术后并发症的发生可以延长患者的生存时间。Objectives To investigate the survival and prognosis of patients undergoing pancreaticoduodenectomy, and to discuss the influential factors of the survival and prognosis. Methods The clinical and pathological data were analyzed retrospectively of 97 pancreatic cancer patients who had undergone pancreaticoduodenectomy between January 2006 and December 2011 at our institution. Then, we analyzed the factors influencing the prognosis of patients such as age, lymphatic metastasis, vessel reconstruction mode, postoperative complications, tumor size and differential degree. Results The average survival of the 97 patients who received pancreaticoduodenectomy combined with vascular resection was 11. 9 months, and the 1-, 2-, and 3-year survival rates were 30. 3%, 14. 1%, and 8. 1%, respectively. The incidence of postoperative complications was 20.6%, and the mortality rate was 8.2%. Conclusions The two independent factors affecting the postoperative survival time were the degree of tumor differentiation and the presence or absence of postoperative complications. Reducing the incidence of postoperative complications can prolong the survival time of the patients.

关 键 词：胰腺肿瘤 胰十二指肠切除术 血管外科手术 

分 类 号：R735.9[医药卫生—肿瘤]