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手握强度预测胰腺二切除术后的主要并发症:一项前性观察研究
Lohith P1, Deeksha Kapoor1, Amanjeet Singh1
1Department of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery, Medanta-The Medicity Hospital, Gurugram, India.
Annals of hepato-biliary-pancreatic surgery
|September 16, 2025
概括
手握强度 (HGS) 是胰腺双管切除术 (PD) 后主要并发症和死亡率的关键预测因素. 手术前的HGS评估可以识别患有PD手术后不良结果风险较高的患者.
科学领域:
- 手术瘤学手术瘤学
- 老年人手术是一门老年手术.
- 患者研究成果研究结果
背景情况:
- 胰腺双管切除术 (PD) 仍然是一个高发病率的手术,尽管死亡率下降.
- 术前评估工具,如修改的脆弱性指数 (mFI) 和手握强度 (HGS) 已经显示出预测PD结果的潜力.
- 识别可靠的预测因子对于优化患者护理和手术规划至关重要.
研究的目的:
- 预期评估手术前手握强度 (HGS) 和修改的脆弱指数 (mFI) 的预测值,以预测胰腺除术 (PD) 后的术后结果.
- 确定HGS和mFI是否可以识别PD后患有重大并发症和死亡风险增加的患者.
主要方法:
- 一项前性观察性研究招募了180名连续接受PD的患者,时间在2021年6月至2023年3月之间.
- 收集的手术前数据包括患者特征,mFI和HGS.
- 术后并发症使用Clavien-Dindo (CD) 分类进行分级,并分析了与mFI和HGS的关联.
主要成果:
- 较弱的HGS与严重并发症 (CD等级≥3) (p < 0.001) 和90天死亡率 (p < 0.001) 显著相关.
- 较弱的HGS还预测了更长的住院时间,90天的再入院和整体并发症.
- 高MFI没有达到预测重大并发症的统计学意义 (p = 0.063).
- 多变量分析确定HGS较弱是主要并发症的独立预测因素 (aOR,11.52;p < 0.0001).
结论:
- 手术前手握强度 (HGS) 是评估功能性肉症的一个简单而有效的工具.
- 弱HGS是胰腺双管切除术 (PD) 后主要并发症的独立预测因素.
- 应将HGS测量纳入PD患者的手术前评估,以确定高风险个体.
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