【摘要】 目的探讨影响胰十二指肠切除术后并发症的危险因素。方法回顾性分析该院1998年2月～2009年12月间141例行胰十二指肠切除术的患者的临床资料,选择9个可能对胰十二指肠切除术疗效产生影响的非重复特征性临床因素进行单因素分析,通过Cox模型进行多因素分析。结果血清总胆红素水平、血清白蛋白、术前黄疸持续时间、术前有否减黄治疗、手术时间和术中出血量6个为危险因素(均P<0.05);与并发症发生率、死亡率有关的独立因素为术中出血量、手术时间、术前血清总胆红素水平和黄疸持续时间(均P<0.05)。结论术中出血量、手术时间、术前血清总胆红素水平和黄疸持续时间是影响胰十二指肠切除术后并发症发生率和死亡率的主要危险因素。更多还原

【Abstract】 【Objective】 To investigate the risk factors of postoperative complications of pancreatoduodenectomy.【Methods】 The clinical data of 141 cases with pancreatic carcinoma or periampullary carcinoma,underwent pancreatoduodenectomy at the Third Xiangya Hospital of Central South University from Feb.1998 to Dec.2009,were analyzed.Nine clinicopathologic factors that could possibly influence postoperative mortality and morbidity were selected for univariate analysis and multivariate analysis using Cox proportional hazards model.【Results】 Univariate analysis showed that major risk factors of postoperative mortality and morbidity of the patients were total serum bilirubin level,serum album level,duration of jaundice,decompression of jaundice,operating time,and intra-operative bleeding(P <0.05).Multivariate analysis showed that intra-operative bleeding,operating time,total serum bilirubin level,and duration of jaundice were independent risk factors(P <0.01).【Conclusion】 Postoperative mortality and morbidity of pancreatoduodenectomy for periampullary carcinoma are closely related to intra-operative bleeding,operating time,serum bilirubin level and duration of jaundice.更多还原