利用术前CT评估胰腺因素对胰体尾切除术后胰瘘的影响分析
【摘要】 目的：探讨利用术前CT评估胰腺因素预测胰体尾切除术后临床性胰瘘的发生。方法：收集福建医科大学附属第一医院2011年1月-2018年1月收治的110例行胰体尾切除术的患者的临床资料，术前CT评估包括胰腺预切线厚度、主胰管扩张情况及胰腺质地（胰腺CT值/脾脏CT值）。结果：临床性胰瘘发生率为20%，单因素分析显示胰腺预切线厚度[（18.1±2.8） mm vs （13.7±2.5）mm，P<0.001]及胰腺外恶性病变（5/22 vs 6/88，P=0.027）与临床性胰瘘显著相关。根据受试者工作曲线确定胰腺预切线厚度截止值为15.35 mm（曲线下面积=0.895，P<0.001）。多因素分析显示胰腺预切线厚度≥15.4 mm是临床性胰瘘独立危险因素（OR=28.41，P<0.001）。结论：利用術前CT测量胰腺预切线厚度有助于预测胰体尾切除术后临床性胰瘘的发生。
【关键词】 CT； 胰瘘； 胰体尾切除术
【Abstract】 Objective：To assess whether pancreatic factors obtained with preoperative computed tomography （CT） may predict the occurrence of a clinical postoperative pancreatic fistula （POPF） after distal pancreatectomy（DP）.Method：The clinical data of 110 patients who given distal pancreatectomy admitted to the First Affiliated Hospital of Fujian Medical University from January 2011 to January 2018 were selected，preoperative CT evaluation included pancreatic pre-tangent thickness， main pancreatic duct dilatation and pancreatic texture （pancreatic CT value/splenic CT value）.Result：The incidence of clinical pancreatic fistula was 20%.Univariate analysis showed that the thickness of pancreatic precut line [（18.1±2.8） mm vs （13.7±2.5）mm，P<0.001] and extrapancreatic malignant lesions （5/22 vs 6/88，P=0.027） were significantly correlated with clinical pancreatic fistula.The 15.35 mm cutoff value for TPC was determined according to the receiver operating characteristic （ROC） curve， the area under the ROC curve was 0.895（P<0.001）. TPC≥15.4 mm was identified as a significant independent risk facto...
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