胰漏危险度评分系统用于预测胰十二指肠切除术后胰漏低风险患者的价值  

Prediction Value of Fistula Risk Score in Patients With Low Risk of Clinically Relevant Pancreatic Fistula After Pancreaticoduodenectomy

作　　者：李慕行 王行雁[1] 原春辉[1] 马朝来[1] 蒋斌[1] 李磊[1] 张利[1] 修典荣[1] Li Muxing;Wang Hangyan;Yuan Chunhui(Department of General Surgery, Peking University Third Hospital, Beijing 100191, China)

机构地区：[1]北京大学第三医院普通外科

出　　处：《中国微创外科杂志》2020年第3期224-226,258,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京大学第三医院临床重点项目孵育项目A类(BYSY2018025)

摘　　要：目的探讨胰漏危险度评分系统(Fistula Risk Score,FRS)预测胰十二指肠切除术后临床相关胰漏(clinically relevant pancreatic fistula,CRPF)低风险患者的价值。方法回顾性分析2015年1月~2017年6月我科90例胰十二指肠切除术的临床资料,使用剂量-反应关系及诊断效能四格表法分析FRS在预测胰十二指肠切除术后CRPF低风险患者中的价值。结果共19例发生CRPF,其中B、C级胰漏分别为17、2例;发生时间:2例术后第8天发生,2例术后第10天发生,5例术后第14天发生,2例术后第16天发生,8例术后第21天发生。对90例进行FRS评分与CRPF发生的剂量-反应关系分析显示,FRS<4分的25例均无CRPF发生,敏感性100.0%(19/19),阴性预测值100.0%(25/25)。结论FRS对于发生CRPF风险低的患者预测价值较好,对于FRS<4分的患者可尝试采取更为积极的快速康复方案。Objective To evaluated the prediction value of Fistula Risk Score(FRS)in patients with low risk of clinically relevant pancreatic fistula(CRPF)after pancreaticoduodenectomy(PD).Methods Clinical data of 90 patients who underwent PD from January 2015 to June 2017 in our department was retrospectively analyzed.The relationship between FRS and CRPF was analyzed by using dose-response relationship and fourfold table for diagnostic efficiency.Results There were 19 cases of CRPF,including 17 cases of grade B and 2 cases of grade C pancreatic leakage.The time of occurrence was 2 cases occurred on the 8th day,2 cases on the 10th day,5 cases on the 14th day,2 cases on the 16th day and 8 cases on the 21st day.The dose-response relationship evaluation of the 90 patients identified that no CRPF occurred in the 25 patients with FRS<4 points.The corresponding sensitivity was 100.0%(19/19)and the negative predictive value was 100.0%(25/25).Conclusions FRS has a better predictive value for patients with low risk of CRPF.For patients with FRS<4 points,a more active rapid rehabilitation program can be used.

关 键 词：胰漏危险度评分系统 临床相关胰漏 

分 类 号：R73[医药卫生—肿瘤]