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胰十二指肠切除术后出血的危险因素及治疗：423例病例系列研究

Risk Factors and Treatment for Hemorrhage after Pancreaticoduodenectomy: A Case Series of 423 Patients.

作者信息

Gao Feng, Li Jianguo, Quan Shengwei, Li Fujun, Ma Donglai, Yao Lei, Zhang Ping

机构信息

Department of General Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin 150000, China.

Department of General Surgery, First Affiliated Hospital of Jilin University, Changchun 130000, China; Department of General Surgery, Heilongjiang Province Hospital, Harbin 150000, China.

出版信息

Biomed Res Int. 2016;2016:2815693. doi: 10.1155/2016/2815693. Epub 2016 Nov 16.

DOI:10.1155/2016/2815693
PMID:27975049
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5128684/
Abstract

The study aimed to investigate the risk factors of postpancreatectomy hemorrhage (PPH) after pancreaticoduodenectomy (PD). A retrospective analysis of 423 patients who underwent PD between January 2008 and January 2014 was conducted. The overall incidence and all-cause mortality of PPH were 9.9% (42/423) and 2.1% (9/423), respectively. Independent risk factors of early PPH were revascularization (odds ratio (OR) = 6.786; 95% confidence interval (95% CI): 1.785-25.792; = 0.005), history of abdominal surgery (OR = 5.009; 95% CI: 1.968-12.749; = 0.001), and preoperative albumin levels (OR = 4.863; 95% CI: 1.962-12.005; = 0.001). Independent risk factors of late PPH included postoperative pancreatic leakage (OR = 4.696; 95% CI: 1.605-13.740; = 0.005), postoperative biliary fistula (OR = 6.096; 95% CI: 1.575-23.598; = 0.009), postoperative abdominal infection (OR = 4.605; 95% CI: 1.108-19.144; = 0.036), revascularization (OR = 9.943; 95% CI: 1.900-52.042; = 0.007), history of abdominal surgery (OR = 8.790; 95% CI: 2.779-27.806; < 0.001), and preoperative albumin levels (OR = 5.563; 95% CI: 1.845-16.776; = 0.002).

摘要

本研究旨在探讨胰十二指肠切除术（PD）后胰十二指肠切除术后出血（PPH）的危险因素。对2008年1月至2014年1月期间接受PD的423例患者进行了回顾性分析。PPH的总体发生率和全因死亡率分别为9.9%（42/423）和2.1%（9/423）。早期PPH的独立危险因素为血管重建（比值比（OR）=6.786；95%置信区间（95%CI）：1.785 - 25.792；P = 0.005）、腹部手术史（OR = 5.009；95%CI：1.968 - 12.749；P = 0.001）和术前白蛋白水平（OR = 4.863；95%CI：1.962 - 12.005；P = 0.001）。晚期PPH的独立危险因素包括术后胰瘘（OR = 4.696；95%CI：1.605 - 13.740；P = 0.005）、术后胆瘘（OR = 6.096；95%CI：1.575 - 23.598；P = 0.009）、术后腹腔感染（OR = 4.605；95%CI：1.108 - 19.144；P = 0.036）、血管重建（OR = 9.943；95%CI：1.900 - 52.042；P = 0.007）、腹部手术史（OR = 8.790；95%CI：2.779 - 27.806；P < 0.001）和术前白蛋白水平（OR = 5.563；95%CI：1.845 - 16.776；P = 0.002）。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ed8/5128684/57f51172a09e/BMRI2016-2815693.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ed8/5128684/57f51172a09e/BMRI2016-2815693.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ed8/5128684/57f51172a09e/BMRI2016-2815693.001.jpg

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Post-pancreaticoduodenectomy hemorrhage: risk factors, managements and outcomes.胰十二指肠切除术后出血：危险因素、管理及结局
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Machine learning approach to predict postpancreatectomy hemorrhage following pancreaticoduodenectomy: a retrospective study.机器学习方法预测胰十二指肠切除术后胰瘘出血：一项回顾性研究。
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