胰十二指肠切除术后胰瘘相关危险因素分析: 单中心回顾性研究

张 奇1, 任 利*2
1、青海大学临床医学院
2、青海大学附属医院普外科

摘要


目的本研究旨在分析胰十二指肠切除术PancreaticoduodenectomyPD后发生临床相关胰瘘clinically
relevant postoperative pancreatic fistulaCR-POPF的危险因素为临床防治提供依据。方法回顾性收集2019年1
月至2025年12月青海大学附属医院99例行PD患者的临床资料根据是否发生B/C级胰瘘分为胰瘘组36例和
非胰瘘组。结果采用单因素和多因素Logistic回归分析相关危险因素。单因素分析显示术前总胆红素TBiL、
白蛋白ALB以及术中出血量、胰管直径、术后谷丙转氨酶ALT、谷草转氨酶AST、白蛋白和降钙素原
PCT与胰瘘相关均P<0.05。多因素分析进一步明确术前白蛋白OR=6.060、总胆红素OR=9.139术
后白蛋白OR=6.051、PCTOR=5.028、白细胞计数OR=1.081及胰管直径≤3mmOR=2.502为CRPOPF的 独 立 危 险 因 素。结 论术 前 主 胰 管 直 径 3mm、ALB≥35g/L、TBiL≥17.1μmol/L 以 及 术 后 第3天
PCT≥0.5ng/ml、ALB30g/L是CR-POPF的独立危险因素。基于上述因素构建的风险预测模型有助于早期识别高
危患者指导临床干预。

关键词


胰十二指肠切除术;胰瘘;胰管直径;总胆红素;降钙素原

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