胰十二指腸切除術(shù)后胃排空延遲的危險(xiǎn)因素分析

連福珍（廣東藥學(xué)院附屬第一醫(yī)院　普外一科/肝膽胰外科，廣東　廣州　510080）

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胰十二指腸切除術(shù)后胃排空延遲的危險(xiǎn)因素分析

連福珍
（廣東藥學(xué)院附屬第一醫(yī)院普外一科/肝膽胰外科，廣東廣州510080）

[摘 要]目的 探討胰十二指腸切除術(shù)后發(fā)生胃排空延遲的危險(xiǎn)因素。方法 回顧性分析2011年1月至2015年1月期間在我院接受胰十二指腸切除術(shù)的患者69例臨床資料，分析性別、年齡、BMI、基礎(chǔ)疾病、臨床癥狀、血清白蛋白水平、手術(shù)情況、胰瘺、腹腔積液及切口感染對(duì)胰十二指腸切除術(shù)后胃排空延遲的影響。結(jié)果 單因素分析結(jié)果顯示，BMI≥25 kg/m2、術(shù)后發(fā)生胰瘺、腹腔積液的患者胰十二指腸切除術(shù)后胃排空延遲的發(fā)生率顯著升高（P＜0.05）；多因素Logistic回歸分析結(jié)果顯示，BMI≥25 kg/m2、術(shù)后發(fā)生胰瘺、腹腔積液均是胰十二指腸切除術(shù)后發(fā)生胃排空延遲的危險(xiǎn)因素（P＜0.05）。結(jié)論 BMI≥25 kg/m2、術(shù)后胰瘺、腹腔積液均是胰十二指腸切除術(shù)后發(fā)生胃排空延遲的危險(xiǎn)因素，臨床應(yīng)及早采取防治策略，以降低胃排空延遲的發(fā)生率。

[關(guān)鍵詞]胰十二指腸切除；胃排空延遲；危險(xiǎn)因素

Risk factors analysis of delayed gastric emptying after pancreatico-duodenectomy LIAN Fuzhen.

The First Ward of General Surgery/Department of Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China

Abstract objectiveTo investigate the risk factors of delayed gastric emptying after pancreatico-duodenectomy.MethodsThe clinical data of 69 patients underwent pancreatico- duodenectomy were retrospectively analyzed to summarize the risk factors of delayed gastric emptying,including gender,age,BMI,basic diseases,clinical symptoms,serum albumin level,operation condition,pancreatic fistula,peritoneal effusion and wound infection.ResultsUnivariate analysis showed that the incidence rate of delayed gastric emptying after pancreatico-duodenectomy in patients with BMI≥25 kg/m2,postoperative pancreatic fistula and abdominal effusion was significant higher(P＜0.05).Multivariate Logistic regression analysis showed that the risk factors of delayed gastric emptying after pancreatico-duodenectomy included BMI≥25 kg/m2,postoperative pancreatic fistula and peritoneal effusion(P＜0.05).ConclusionThe risk factors of delayed gastric emptying after pancreatico-duodenectomy include BMI≥25 kg/m2,postoperative pancreatic fistula and peritoneal effusion.Preventive strategies should be taken to reduce the incidence of delayed gastric emptying.

Key words pancreatico-duodenectomy; delayed gastric emptying; risk factors

胰十二指腸切除術(shù)是治療胰、十二指腸病變的重要方法，手術(shù)需要對(duì)病灶侵襲的胰腺、鄰近十二指腸、膽管下端等組織進(jìn)行切除并進(jìn)行消化道重建。胃排空延遲是胰十二指腸切除術(shù)后常見(jiàn)的并發(fā)癥，其發(fā)生與手術(shù)切除對(duì)胃腸神經(jīng)傳導(dǎo)造成的損傷、植物神經(jīng)功能損傷以及消化道重建導(dǎo)致局部張力改變等因素有關(guān)[2]。臨床研究顯示，胰十二指腸切除術(shù)后胃排空延遲的發(fā)生率在20%以上[3]。……