肌少症与胰十二指肠切除术后患者结局的关系  

The relationship of sarcopenia in patients undergoing pancreaticoduodenectomy with outcome

作　　者：曹勤[1] 丁佑铭[1] 陈孟荣[2] 汪斌[1] 陈晓燕[1] 赵凯亮[1] 陈辰[1] 戈建辉 Cao Qia, Diag Youmiag, Chen Mengrong, Chen Mengyong, Wang Bin, Chen Xiaoyan, Zhao Kailiang, Chen Chen, Ge Jianhui.(Department of Hepato and Biliary Laparoscopic Surgery, The Renmin Hospital of Wuhan Uni- versity, Wuhan 430060, Chin)

机构地区：[1]武汉大学人民医院肝胆腔镜外科,430060 [2]武汉大学人民医院放射科,430060

出　　处：《中华临床营养杂志》2018年第1期40-45,共6页Chinese Journal of Clinical Nutrition

摘　　要：目的探讨肌少症与胰十二指肠切除术后患者预后的关系。方法收集2011年3月至2016年8月就诊于武汉大学人民医院行胰十二指肠切除术的116例患者的并发症及生存率随访资料，并进行统计学分析。结果116例患者中，肌少症49例（42．2％）。肌少症组患者术后发生并发症的概率较非肌少症组显著增加（所有并发症：59．2％比38．8％，χ2=4．714，P=0．030；Clavien-DindoⅢ级及以上：26．5％比10．4％，χ2=5．130，P=0．024），术后恢复时间较非肌少症组显著延长[（17．33±6．54）d比（13．46±9．32）d，P=0．013]。Kaplan-Meier生存分析结果显示，肌少症是患者术后总生存率及无复发生存率显著降低的危险因素（P〈0．05）。Cox比例风险模型分析结果显示，肌少症是术后总生存率及无复发生存率降低的危险因素（总生存率：风险比=2．285，95％CI=1．521-3．431；无复发生存率：风险比=2．167，95％CI=1．445～3．248）。结论肌少症是胰十二指肠切除术后患者预后不佳的危险因素，合并肌少症的患者不仅术后并发症发生的概率增加，总生存率及无复发生存率也显著下降。Objective To explore the prognostic value of sarcopenia in patients undergoing pancreati- coduodenectomy. Method Clinieopathologic data and follow-up information of 116 patients undergoing pancre- aticoduodenectomy at Renmin Hospital of Wuhan University between March 2011 and August 2016 were collect- ed for statistical analysis. Results Among the 116 patients, the prevalence of sarcopenia was 42. 2% （ n = 49）. When compared to the rest of the patients who did not have sarcopenia, the sarcopenia group had longer recov- ery time [ （ 17.33±6. 54） d vs. （ 13.46±9. 32） d, P=0. 013] and increased risk of complications （ complica- tions in general, 59. 2% vs. 38. 8%, χ2 = 4. 714, P = 0. 030; Clavien-Dindo ≥ 3 ： 26. 5% vs. 10. 4%,χ2 = 5. 130, P = 0. 024）. Both the Kaplan-Meier survival analysis （P〈0. 05） and the Cox proportional hazard model （ overall survival ： hazard ratio = 2. 285, 95% CI = 1. 521 - 3.431 ; recurrence-free survival, hazard ratio = 2. 167, 95% CI= 1. 445-3. 248） indicated sarcopenia as the risk factor for poorer overall survival and recur- rence-free survival. Conclusions Sarcopenia was an independent predictor of poor prognosis for patients under- going pancreaticoduodenectomy. Patients with sarcopenia had higher risk of developing complications after sur- gery and lower overall survival rate and recurrence-free survival rate.

关 键 词：肌少症 胰十二指肠切除术 并发症 总生存率 无复发生存率 

分 类 号：R735.9[医药卫生—肿瘤]