胰十二指肠切除术后死亡的相关危险因素分析
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吴阳

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Analysis of risk factors associated with mortality after pancreatoduodenectomy
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    目的 探讨胰十二指肠切除术(PD)后与手术死亡有关的危险因素,以降低手术病死率。
    方法 回顾9年间接受PD连续123例患者的临床资料。分析变量包括临床资料、实验室数据、手术因素、病理诊断和并发症。
    结果 术后30d内病死率为7.3%。腹腔出血(OR=17.954)、糖尿病(OR=7.097)、消化道出血(OR=7.789)、术前血清白(清)蛋白(OR=10.689)和手术失血量(OR=5.473)为独立的危险因素。
    结论 PD手术死亡的主要危险因素为术前血清白(清)蛋白过低、糖尿病、手术失血量大、术后消化道出血及腹腔出血。因此,围手术期应注意对这些危险因素进行处理。

    Abstract:

    Abstract:Objective To evaluate the risk factors associated with operative death after pancreatoduodenectomy(PD) and thus be able to decrease mortality.
    Methods The data of 123 consecutive patients undergoing PD during 9 years were reviewed. The variables analyzed were clinical data, laboratory data, operative factors, pathological diagnosis, and complications.
    Results The 30day postoperative mortality rate was 7.3 percent. Postoperative intraabdominal hemorrhage(OR=17.954), diabetes(OR=7.097), gastrointestinal hemorrhage (OR=7.789), preoperative serum albumin concentration(OR=10.689) and amount of operative blood loss(OR=5.473) were independent risk factors.
    Conclusions The chief risk factors associated with operative death after PD are low concentration of preoperative serum albumin, diabetes, large amount of operative blood loss, and postoperative intraabdominal and gastrointestinal hemorrhage. These risk factors should be specifically considered in the perioperative management of the patients.

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王志军,吴阳,谢志徵,王陆林.胰十二指肠切除术后死亡的相关危险因素分析[J].中国普通外科杂志,2005,14(5):17-.
DOI:10.7659/j. issn.1005-6947.2005.05.016

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  • 收稿日期:2004-07-15
  • 最后修改日期:2004-12-27
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  • 在线发布日期: 2005-05-25