摘要
目的参照2016年国际胰瘘小组更新的胰瘘分级,探讨胰十二指肠切除术后胰瘘的危险因素,并尝试建立胰瘘风险预测模型。方法回顾性分析徐州医科大学附属医院2014年1月至2017年3月收治的161例行胰十二指肠切除术病人的临床资料,应用单因素及多因素分析,确定术后胰瘘发生的独立危险因素,并以此建立术后胰瘘的风险预测模型,通过受试者工作特征曲线(ROC)及曲线下面积(AUC)计算其灵敏度和特异度。结果本组病人胰瘘发生率17.39%(28/161),其中B级胰瘘16.15%(26/161),C级胰瘘1.24%(2/161),多因素分析结果显示,BMI(P<0.05)、胰腺质地(P<0.01)和胰管直径(P<0.05)为术后胰瘘发生的独立危险因素,据此建立术后胰瘘预测模型,ROC曲线下面积0.750(95%CI:0.658~0.841),曲线拐点对应的计算概率为15.36%,对应的灵敏度为0.786,特异度为0.639。结论BMI、胰腺质地及胰管直径为胰十二指肠切除术后胰瘘发生的独立危险因素,建立的术后胰瘘预测模型灵敏度、特异度较高,可为术后胰瘘的预测提供参考。
Objective To explore the risk factors of pancreatic fistula after pancreaticoduodenectomy with reference to the updated pancreatic fistula grading in the International Study Group on Pancreatic Surgery in 2016,and to establish the risk prediction model of pancreatic fistula.Methods The clinical data of 161 patients with pancreaticoduodenectomy were analyzed retrospectively from January2014 to March 2017 in the Department of Cancer Surgery,Affiliated Hospital of Xuzhou Medical University.Univariate and multivariate analysis were used to determine the independent risk factors of postoperative pancreatic fistula,and the risk prediction model of postoperative pancreatic fistula was established.The sensitivity and specificity were calculated by the receiver operating characteristic curve(ROC)and the area under the curve(AUC).Results The incidence of pancreatic fistula in this group was 17.39%(28/161),including 16.15%(26/161)of grade B pancreatic fistula and 1.24%(2/161)of grade C pancreatic fistula.Multivariate analysis showed that BMI(P<0.05),pancreatic texture(P<0.01)and pancreatic duct diameter(P<0.05)were the independent risk factors of postoperative pancreatic fistula.The model of pancreatic fistula was established.The area under the ROC curve was 0.750(95%CI:0.658~0.841).The calculated probability of curve inflexion is 15.36%,the corresponding sensitivity is 0.786,the specificity is0.639.Conclusion BMI,pancreatic texture and pancreatic duct diameter are independent risk factors of pancreatic fistula after pancreaticoduodenectomy.The sensitivity and specificity of pancreatic fistula model in postoperative pancreatic fistula model are higher,which may be postoperative pancreatic Fistula is provided for reference.
作者
吴耐
任泽强
张蓬波
张秀忠
张冲
龚帅
张易
WU Nai;REN Zeqiang;ZHANG Pengbo;ZHANG Xiuzhong;ZHANG Chong;GONG Shuai;ZHANG Yi(Department of Pancreatic Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221003,China)
出处
《安徽医药》
CAS
2019年第7期1380-1383,共4页
Anhui Medical and Pharmaceutical Journal
关键词
胰十二指肠切除
胰瘘
危险因素
风险预测
Pancreaticoduodenectomy
Pancreatic fistula
risk factors
Risk prediction
