【摘 要】
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目的 探讨125Ⅰ粒子植入术治疗晚期胰腺癌术后胰瘘发生率及影响因素.方法 79例晚期胰腺癌病人行开腹125Ⅰ粒子植入术,根据术后是否发生胰瘘,分为发生胰瘘组和未发生组,记录两
【机 构】
：
荆州市第二人民医院普外科,湖北省黄石市中心医院麻醉科,中国医科大学附属第四医院
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目的 探讨125Ⅰ粒子植入术治疗晚期胰腺癌术后胰瘘发生率及影响因素.方法 79例晚期胰腺癌病人行开腹125Ⅰ粒子植入术,根据术后是否发生胰瘘,分为发生胰瘘组和未发生组,记录两组病人一般情况,所有病人随访至2014年12月31日,记录病人生存时间.利用Logistic多因素分析对相关危险因素进行分析,利用Kaplan-Meier对病人生存期进行分析.结果 79例病人均顺利完成125Ⅰ粒子植入,均未出现死亡病例,未出现感染、出血等并发症,14例出现胰瘘,发生率为17.7％;单因素分析发现,肿瘤位置、放置粒子数和术后应用胰液分泌抑制药则是病人术后发生胰瘘的相关影响因素(P＜0.05),多因素Logistic回归分析显示,肿瘤位置、放置粒子数和术后应用胰液分泌抑制药是影响病人术后发生胰瘘的独立危险因素(P＜0.05);发生胰瘘组病人中位生存期为8.4个月,未发生组病人中位生存期为11.5个月,差异有统计学意义(P＜0.05).结论 125Ⅰ粒子植入术可用于晚期胰腺癌病人治疗,粒子植入位置及数量、术后应用胰液分泌抑制药是影响术后胰瘘发生的因素,有效减少胰瘘发生可能对延长病人生存期具有重要意义.
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