胰腺切除术后延迟性出血的相关危险因素。
Risk factors associated with delayed haemorrhage after pancreatic resection.
机构信息
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
出版信息
HPB (Oxford). 2012 Oct;14(10):684-7. doi: 10.1111/j.1477-2574.2012.00518.x. Epub 2012 Jul 19.
BACKGROUND
Delayed haemorrhage (DH) is a life-threatening complication of pancreatic resection (PR) and the mortality rate for DH is very high. However, the risk factors and prognostic factors associated with DH are rarely evaluated.
METHODS
A pancreatic resection was performed on 457 patients. Delayed haemorrhage was defined as bleeding from the surgical site ≥ 5 days after PR. Risk factors for DH were assessed according to demographics and pathological and operative parameters. Prognostic factors after DH were evaluated for the shock index (heart rate/systolic blood pressure) and systemic inflammatory response syndrome (SIRS) scores.
RESULTS
Of the 457 patients, 11 (2.4%) experienced DH after PR. Logistic regression analysis showed that age >60 years and a diagnosis of malignant disease were risk factors for DH. The shock index and SIRS scores at the onset of DH were significantly higher in patients who died as compared with those patients that survived (P < 0.05).
DISCUSSION
PR-associated DH carries an increased risk for patients aged >60 years with malignant disease. Prognostic factors were a shock index score ≥ 0.7 and SIRS at the onset of DH.
背景
延迟性出血（DH）是胰腺切除术（PR）的一种危及生命的并发症，DH 的死亡率非常高。然而，DH 相关的风险因素和预后因素很少被评估。
方法
对 457 例患者进行了胰腺切除术。DH 定义为 PR 后≥5 天手术部位出血。根据人口统计学和病理及手术参数评估 DH 的风险因素。评估 DH 后休克指数（心率/收缩压）和全身炎症反应综合征（SIRS）评分的预后因素。
结果
在 457 例患者中，11 例（2.4%）在 PR 后发生 DH。Logistic 回归分析表明，年龄>60 岁和恶性疾病诊断是 DH 的危险因素。与存活患者相比，DH 发病时的休克指数和 SIRS 评分显著更高（P<0.05）。
讨论
PR 相关的 DH 使年龄>60 岁且患有恶性疾病的患者面临更高的风险。预后因素是 DH 发病时的休克指数评分≥0.7 和 SIRS。
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