摘要
目的探讨胰头癌胰十二指肠切除术后复发的危险因素分析及护理策略。方法选取2014年2月-2017年5月在我院进行胰十二指肠切除术治疗的胰头癌患者52例作为研究对象。通过查阅患者的临床资料包括患者的年龄、性别、肿瘤最大直径、生化指标、肿瘤标志物、术中出血量、转移情况、肿瘤分化、术后并发症和术后化疗等信息。根据对患者2年的随访结果,筛选出胰头癌行胰十二指肠切除术后的复发患者和非复发患者,采用Logistic回归分析术后复发的危险因素。结果2年的随访中出现复发的有32例,非复发20例。其中复发患者的白蛋白、CA125、脉管转移、淋巴结转移、肿瘤分化以及术后化疗与非复发患者对比,差异有统计学意义(P<0.05);经多因素Logistic回归分析,CA125浓度≥35 U/m L、脉管转移、淋巴结转移、肿瘤"中、高分化"及术后化疗均是胰头癌行PD切除术后复发的危险因素,差异有统计学意义(P<0.05)。结论CA125浓度≥35 U/ml、脉管转移、淋巴结转移、肿瘤"中、高分化"以及术后化疗均是胰头癌行胰十二指肠切除术后复发的危险因素,医护人员应重点关注这些潜在的危险因素,密切监测相关指标和加强基础护理。
Objective To explore the risk factors and nursing strategies of recurrence of pancreatic head cancer after pancreaticoduodenectomy.Method Fifty-two patients with pancreatic head cancer who underwent pancreaticoduodenectomy in our hospital from February 2014 to May 2017 were selected as the study subjects.The clinical data included age,sex,maximum diameter of tumors,biochemical indicators,tumor markers,intraoperative bleeding volume,metastasis,differentiation of tumors,postoperative complications,post-operative chemotherapy and other information.According to the 2-year follow-up results of the patients,the recurrent and non-recurrent patients after pancreaticoduodenectomy for pancreatic head cancer were screened out,and the risk factors of recurrence were analyzed by logistic regression.Results During the 2-year followup,32 cases had recurrence and 20 cases had no recurrence.There were significant differences in albumin,CA125,vascular metastasis,lymph node metastasis,tumor differentiation and post-operative chemotherapy between recurrent patients and non-recurrent patients(P<0.05).Multivariate logistic regression analysis showed that the concentration of CA125(≥35 U/mL),vascular metastasis,lymph node metastasis,"moderate to high differentiation"of tumors and post-operative chemotherapy were all recurrences of pancreatic head cancer after PD resection.There were significant differences in risk factors(P<0.05).Conclusion CA125 concentration(≥35 U/mL),vascular metastasis,lymph node metastasis,tumor"moderate to high differentiation"and postoperative chemotherapy are all risk factors for recurrence of pancreatic head cancer after pancreaticoduodenectomy.Medical staff should pay attention to these potential risk factors,closely monitor relevant indicators and strengthen basic nursing care.
作者
于洋
谭晓冬
YU Yang;TAN Xiaodong(Pancreatic Thyroid Surgery Department,Shengjing Hospital of China Medical University,Shenyang Liaoning 110004,China)
出处
《中国继续医学教育》
2020年第6期187-190,共4页
China Continuing Medical Education
基金
辽宁省自然科学基金(名称：外泌体TNC介导的信号通路在胰腺癌侵袭转移中的作用机制；编号：20180530068)
关键词
胰腺癌
胰十二指肠切除术
复发
危险因素
预后
临床护理策略
pancreatic cancer
pancreaticoduodenectomy
recurrence
risk factors
prognosis
clinical nursing strategies
