基于倾向性评分匹配评价PBD对PD术后并发症的影响  

Effect of PBD on Postoperative Complications of PD:A Propensity Score Matched Analysis

作　　者：周世波 谭震 韩丽 周黎晨 吉华 唐政 赵治戎 戴睿武 ZHOU Shibo;TAN Zhen;HAN Li(College of Clinical Medicine Southwest Medical University,Sichuan 646000,China)

机构地区：[1]西南医科大学临床医学院,泸州646000 [2]中国人民解放军西部战区总医院全军普外中心,成都610083

出　　处：《医学研究杂志》2022年第10期92-97,共6页Journal of Medical Research

基　　金：中国人民解放军西部战区总医院“星火”青年创新人才培养基金资助项目。

摘　　要：目的探讨术前胆管引流(preoperative biliary drainage,PBD)对低位恶性梗阻性黄疸患者胰十二指肠切除术(pancreaticoduodenectomy,PD)术后并发症的影响。方法回顾性分析2013年1月~2020年1月中国人民解放军西部战区总医院行PD术的患者临床资料。根据是否PBD分为PBD组和非PBD组,采用倾向性评分匹配均衡两组基线资料,比较两组患者术后并发症的差异。结果倾向性评分匹配后两组基线数据差异均无统计学意义(P均>0.05)。PBD组术后总体并发症发生率明显低于非PBD组(P<0.001),术后住院时间明显比非PBD组短(P=0.01)。单因素及多因素Logistic回归分析显示,PBD是低位恶性梗阻性黄疸患者术后并发症的独立保护因素(OR=0.20,95%CI:0.08~0.51,P=0.001)。结论PBD可降低低位恶性梗阻性黄疸患者PD术后总体并发症发生率,缩短术后住院时间,且PBD是PD术后并发症的独立保护因素。Objective To investigate the effect of preoperative biliary drainage(PBD)on complications after pancreaticoduodenectomy(PD)in patients with low-level malignant obstructive jaundice.Methods The clinical data of patients with low-level malignant obstructive jaundice who underwent pancreaticoduodenectomy in the Department of Hepatobiliary and Pancreatic surgery of General Hospital of Western Theater Command from January 2013 to January 2020 were analyzed retrospectively.Patients were divided into PBD group and non-PBD group.The method of 1∶1 propensity score matching was used to equalize the baseline data of the two groups,and the intraoperative data and postoperative complications of the two groups were analyzed.Results There was no significant difference in baseline data between the two groups after propensity score matching(P>0.05).The overall incidence of postoperative complications in PBD group was significantly lower than that in non-PBD group(P<0.001).The postoperative hospital stay in the PBD group was significantly shorter than that in the non-PBD group(P=0.01).It was showed that PBD was an independent protective factor for postoperative complications in patients with low-level malignant obstructive jaundice by the Univariate and multivariate Logistic regression analysis(OR=0.20,95%CI:0.08-0.51,P=0.001).Conclusion PBD in patients with low-level malignant obstructive jaundice can reduce the overall incidence of complications after PD,shorten postoperative hospital stay.PBD is an independent protective factor for postoperative complications after PD.

关 键 词：低位恶性梗阻性黄疸 术前胆管引流 胰十二指肠切除术 倾向性评分匹配 

分 类 号：R656[医药卫生—外科学]