术后血糖联合胰腺-内脏脂肪CT值比对胰十二指肠切除术后胰瘘预测价值分析  

The ratio of postoperative blood glucose combined with pancreatic-visceral fat CT value was predictive for pancreatic leakage after pancreaticoduodenectomy

作　　者：张鸿 武科成 刘宇[2] ZHANG Hong;WU Kecheng;LIU Yu(不详;Department of Hepatobiliary and Pancreas Surgery,The First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030000,China)

机构地区：[1]山西医科大学第一临床医学院,030000 [2]山西医科大学第一医院胆胰外科

出　　处：《临床外科杂志》2024年第7期683-686,共4页Journal of Clinical Surgery

摘　　要：目的研究胰十二指肠切除术(PD)后胰瘘(POPF)发生率与血糖及胰腺-内脏脂肪CT值比的相关性。方法选取2018年1月~2022年12月接受PD的病人94例,分析术前胰腺-内脏脂肪CT值比,检测术后1天血糖、血生化以及其他相关指标,单因素及多因素Logistic回归分析POPF发生的高危因素。结果94例病人中,POPF B/C级20例(21.3%)。Logistic回归分析结果显示,胰腺-内脏脂肪CT值比、术前淋巴细胞/单核细细胞、术后第1天血糖是PD病人术后POPF发生的危险因素;开腹手术是PD病人术后POPF发生的独立危险因素。胰腺-内脏脂肪CT值比预测POPF的灵敏度为0.80,特异度为0.58;术后第1天血糖预测POPF的灵敏度为0.55,特异度为0.84;二者联合预测POPF的灵敏度为0.60,特异度为0.78。结论胰腺-内脏脂肪CT值比联合术后第1天血糖可能成为预测PD病人POPF发生的危险因素。Objective To investigate the correlation between the incidence of pancreatic fistula(POPF)after pancreaticoduodenectomy and the CT ratio of pancreatic to visceral fat and blood glucose.Methods 94 patients who underwent PD from January 2018 to December 2022 were selected.Postoperative blood glucose,pancreato-visceral fat CT ratio,blood biochemistry and other relevant indicators were collected to analyze the risk factors for POPF.Results Among the 94 patients,POPF grade B/C in 20 cases(21.3%);Logistic regression analysis showed that CT ratio of pancreas-visceral fat,preoperative lymphocyte/monocyte,and blood glucose on the first day after surgery were risk factors for postoperative pancreatic fistula in PD patients.Laparotomy is an independent risk factor for postoperative pancreatic fistula in PD patients.The sensitivity and specificity of pancreatic-visceral fat CT ratio to predict POPF were 0.80 and 0.58.The sensitivity and specificity of blood glucose prediction of POPF on the first day after surgery were 0.55 and 0.84,respectively.The sensitivity and specificity of POPF prediction were 0.60 and 0.78,respectively.Conclusion CT ratio of pancreatic to visceral fat combined with blood glucose on the first day after surgery may be a risk factor for predicting POPF in PD patients.

关 键 词：胰瘘 血糖 胰腺-内脏脂肪CT值比 胰十二指肠切除术 

分 类 号：R657.5[医药卫生—外科学]