胰腺手术后乳酸升高的频率及其与术后并发症的关系
Lana Othman Mahmmud1, Vilhelmas Bartusevicius2, Åke Norberg1,2
1Dept. of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institute, Stockholm, Sweden.
Surgery in practice and science
|August 12, 2025
概括
胰腺手术后的乳酸水平很常见,但不能可靠地预测并发症. 在全胰腺切除术后乳酸水平的升高可能源于荷尔蒙的变化.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 关键护理医学 关键护理医学
背景情况:
- 在大胰腺手术后经常观察到血乳酸水平升高.
- 术后乳酸水平对预测结果的临床意义尚不清楚.
研究的目的:
- 调查乳酸测量在预测大胰腺手术后术后并发症的临床相关性.
- 为了比较患有并发症和没有并发症的患者之间的乳酸水平.
- 评估乳酸的诊断性能,识别患有并发症风险的患者.
主要方法:
- 对491名接受大胰腺手术的患者进行了回顾性分析.
- 乳酸水平测量到达后麻醉护理单位 (L0),手术后的早晨 (LPOD1),和这些点内的最高值 (LHigh).
- 结果包括Clavien-Dindo等级IIIa-V并发症,手术特异性并发症和住院时间.
主要成果:
- 在患有并发症和没有并发症的患者之间,在任何时间点都没有发现乳酸值的显著差异.
- 接收器操作特征下面区域 (AUROC) 分析表明乳酸在预测并发症方面的诊断性能不佳.
- 乳酸水平在全胰腺切除术后明显高于部分切除术后.
结论:
- 胰腺手术后血乳酸升高是常见的,但对预测术后并发症的临床实用性有限.
- 在全胰腺切除术后观察到的较高乳酸水平可能归因于与该程序相关的固有激素缺陷.
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