胰十二指肠切除术后发生胃排空延迟的危险因素分析  

Risk factors of delayed gastric emptying after pancreaticoduodenectomy

作　　者：粟雨萌 张鸣杰[1] 谈振华[1] 谢平[1] SU Yumeng;ZHANG Mingjie;TAN Zhenhua;XIE Ping(Department of Hepatobiliary and Pancreatic Surgery,Huzhou Central Hospital,Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州市中心医院肝胆胰外科,浙江湖州313000

出　　处：《肝胆胰外科杂志》2024年第10期608-611,616,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨胰十二指肠切除(PD)术后发生胃排空延迟(DGE)的危险因素。方法对湖州市中心医院肝胆胰外科2021年6月至2023年11月期间行PD术治疗的102例患者的临床资料进行回顾性分析。采用单因素分析及多因素Logistic回归对导致DGE发生的危险因素进行分析。结果本组病例术后DGE发生率为45.10%(46/102),其中A级22例、B级14例、C级10例。DGE组(n=46)较无DGE组(n=56)术后住院时间明显延长[(25.7±9.5)d vs(16.2±3.9)d,P<0.001]。单因素分析显示,DGE发生与PD手术时间≥6 h及术后胰瘘(POPF)、腹腔出血、腹腔感染相关。多因素Logistic回归分析显示,POPF(A级,OR=6.280,95%CI 1.826-21.597,P=0.004;B级,OR=28.132,95%CI 2.800-282.611,P=0.005)为PD术后发生DGE的独立危险因素。Spearman秩分析显示,PD术后DGE等级与POPF等级呈正相关(r=0.569,P<0.001)。结论PD术后发生DGE主要与PD手术时间长及PD术后并发症相关。缩短PD手术时间、早期诊断并及时处理胰瘘、腹腔感染、腹腔出血等术后并发症可能有助于减少DGE发生率。Objective To explore the risk factors of delayed gastic emptying(DGE)after pancreaticoduodenectomy(PD).Methods We retrospectively analyzed the clinical data of 102 patients who underwent PD at Huzhou Central Hospital from Jun.2021 to Nov.2023,and evaluated the risk factors that may lead to DGE by univariate analysis and multivariate Logistic regression analysis.Results Among the 102 patients,46 cases(45.10%)developed DGE after PD,including 22 cases of grade A,14 cases of grade B,and 10 cases of grade C.The postoperative hospitalization time in the DGE group(n=46)was significantly longer than that in the non-DGE group(n=56)[(25.7±9.5)d vs(16.2±3.9)d,P<0.001].Univariate analysis indicated that operation time≥6 h,postoperative pancreatic fistula(POPF),postoperative abdominal hemorrhage and abdominal infection were associated with DGE after PD.Multivariate Logistic regression analysis showed that POPF(grade A,OR=6.280,95%CI 1.826-21.597;grade B,OR=28.132,95%CI 2.800-282.611)was an independent risk factor for DGE after PD.Spearman rank analysis showed that POPF grade was positively correlated with DGE grade(r=0.569,P<0.001).Conclusion DGE after PD is mainly associated with long operation time and postoperative complications.Reducing operation time,implementing early diagnosis and timely management of postoperative complications of POPF,abdominal infection and abdominal hemorrhage,which may help to reduce the incidence rate of DGE after PD.

关 键 词：胰十二指肠切除术 胃排空延迟 危险因素 术后并发症 术后胰瘘 

分 类 号：R657.5[医药卫生—外科学] R573[医药卫生—临床医学]