胰十二指肠切除术后腹腔感染的多因素Logistic回归分析及风险评估  

MULTIVARIATE LOGISTIC REGRESSION ANALYSIS AND RISK ESTIMATION OF INTRA-ABDOMINAL INFECTIONS AFTER PANCREATICODUODENECTOMY

作　　者：余安[1] 黄强[1] 刘臣海[1] 林先盛[1] 谢放[1] 朱成林[1] 

机构地区：[1]安徽医科大学附属安徽省立医院普外科,安徽省合肥市230001

出　　处：《中国煤炭工业医学杂志》2016年第12期1675-1679,共5页Chinese Journal of Coal Industry Medicine

基　　金：安徽省科技计划项目(编号:1506c085018);安徽省自然科学基金(编号:1408085QH188)

摘　　要：目的探讨胰十二指肠切除术后腹腔感染的发生率及其高危因素。方法回顾性分析2014年1月—2015年12月行胰十二指肠切除和Child法消化道重建128例患者的临床资料,通过单因素分析与多因素分析方法筛选出与PD术后发生腹腔感染相关的因素,并建立腹腔感染的风险预测模型,应用受试者工作特征曲线(ROC曲线)对该系统检验效能进行评价。结果 128例胰十二指肠切除术后发生腹腔感染52例,发病率为40.6%。单因素分析结果显示术前黄疸>1个月、胰瘘、腹腔积液为危险因素;进一步将其纳入多因素Logistic回归分析,提示三者均为腹腔感染的独立危险因素。根据回归系数建立术后腹腔感染风险预测模型,评分系统的ROC曲线下面积为0.716±0.046(P<0.05)。结论胰十二指肠切除术后腹腔感染的发生与术前黄疸时间、胰瘘和术后腹腔积液密切相关,根据回归方程建立的风险预测模型能够较好的预测胰十二指肠切除术后腹腔感染的发生,术后应重视预防和早期诊治。Objective To explore high - risk factors and morbidity of intra - abdominal infections after pancreati‐coduodenectomy（PD） .Methods The clinical data of 128 patients underwent PD and Child reconstruction between January 2014 and December 2015 were analyzed retrospectively ,the risk factors associsted with intra - abdominal infections after PD were screened using univariate analysis and multivariate logistic regression analysis ,then we built the risk score model based on the regression equation ,the receiver operating characteristic curve（ROC curve） was plotted to analyze the independent risk factors and evaluate its power of model .Results 52 cases occurred in‐tra - abdominal infections among 128 patients underwent PD ,which accounted for 40 .6% .As shown by univari‐ate analysis ,risk factors of infections included period of jaundice 〉 1 month ,pancreatic fistula and seroperitoneum . Multivariate regression analysis showed that period of jaundice 〉 1 month ,pancreatic fistula and seroperitoneum were independent risk factors of intra - abdominal infections .ROC curve showed that AUC of the model based on regression equation was 0 .716 ± 0 .046（P〈0 .05） .Conclusion The occurrence of intra - abdominal infection are closely related to the period of jaundice 〉 1 month ,pancreatic fistula and seroperitoneum .The model based on these factors is reliable in predicting the occurrence of intra - abdominal infection ;surgeon should pay attention to prevention and early diagnosis .

关 键 词：胰十二指肠切除术 腹腔感染 LOGISTIC回归分析 

分 类 号：R657.5[医药卫生—外科学]