老年患者胰十二指肠切除术后并发症的危险因素分析  

Analysis of risk factors for post-pancreaticoduodenectomy complications in elderly patients

作　　者：朱东明[1] 陆凯[1] 易彬[1] 张立峰[1] 李烨[1] 张逸[1] 张子祥[1] 周健[1] 李德春[1] 

机构地区：[1]苏州大学附属第一医院普外科,215006

出　　处：《中华老年医学杂志》2014年第12期1320-1323,共4页Chinese Journal of Geriatrics

基　　金：江苏省科研项目（Q201402）

摘　　要：目的探讨老年患者胰十二指肠切除术后并发症的危险因素。方法回顾2008年1月至2013年12月共112例年龄超过65岁的胰十二指肠切除术临床资料，分析术后并发症的发生情况和危险因素。结果术后各种并发症共39例，发生率为34．8％，死亡4例，病死率为3．6％。Logistic回归分析显示，发生并发症的危险因素依次为胰管支撑管（OR=2．85）、总胆红素水平（OR=2．67）、术前并发症（OR=2．35）、白蛋白水平（OR=1．87）、主胰管直径（OR=1．24），手术者经验（OR=0．35）为保护性因素。结论年龄不是胰十二指肠切除术的禁忌证，有针对性地对高危因素进行客观评估并采取相应的预防措施，能有效降低术后并发症的发生。Objective To investigate risk factors for postoperative complications in elderly patients who have undergone pancreaticoduodenectomy. Methods Clinical data of 112 post- pancreaticoduodenetomy elderly patients at our hospital from January 2008 to December 2013 were collected, and univariate and multivariate analysis were conducted to analyze the incidence of postoperative complications and clinical risk factors. Results Postoperative complications were observed in 39 patients （34.8 %） and 4 patients died from complications （3.6 %）. Logistic regression analysis revealed that pancreatic stent （OR= 2.85）, total serum bilirubin （OR= 2.67）, preoperative complications （OR= 2.35）, serum albumin （OR= 1.87）, and main pancreatic duct diameter （OR= 1.24） were important risk factors for postoperative complications, while surgeon experience （OR= 0.35） was a protective factor. Conclusions Age is not an absolute contraindication for pancreaticoduodenetomy. Assessment of high-risk factors and corresponding preventive measures can reduce postoperative complications effectively.

关 键 词：胰十二指肠切除术 手术后并发症 危险因素 

分 类 号：R656.6[医药卫生—外科学]