中国微创外科杂志2024,Vol.24Issue(3) :184-189.DOI:10.3969/j.issn.1009-6604.2024.03.005

胰腺囊性肿瘤患者行胰体尾切除术后新发糖尿病预后因素的初步探讨

Preliminary Study on Prognostic Factors of New-onset Diabetes Mellitus After Distal Pancreatectomy for Pancreatic Cystic Tumor

李源 张利 李竟麟 修典荣 王行雁
中国微创外科杂志2024,Vol.24Issue(3) :184-189.DOI:10.3969/j.issn.1009-6604.2024.03.005

胰腺囊性肿瘤患者行胰体尾切除术后新发糖尿病预后因素的初步探讨

Preliminary Study on Prognostic Factors of New-onset Diabetes Mellitus After Distal Pancreatectomy for Pancreatic Cystic Tumor

李源 1张利 1李竟麟 1修典荣 1王行雁1
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作者信息

  • 1. 北京大学第三医院普通外科,北京 100191
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摘要

目的 探讨胰腺囊性肿瘤患者行胰体尾切除术后新发糖尿病(new-onset diabetes mellitus,NODM)的预后因素.方法 回顾分析2010 年1 月~2019 年12 月我院92 例胰腺囊性肿瘤行腹腔镜胰体尾切除的临床资料,根据入选和排除标准,共纳入74 例,按照术后随访期间是否发生NODM分为NODM组(n =26)和糖代谢正常组(n =48),采用单因素分析胰腺囊性肿瘤患者行腹腔镜胰体尾切除术后NODM的预后因素.P<0.05 认为差异有显著性,OR>4 认为有潜在临床意义的NODM预后因素.结果 26 例胰腺囊性肿瘤行胰体尾切除术后NODM(35.1%),确诊NODM中位时间为 9 个月(3~56 个月).单因素分析显示颈部胰腺离断颈部(OR =11.000,P =0.000)、有糖尿病家族史(OR =5.000,P =0.004)和BMI≥25.0(OR = 4.333,P =0.007)是术后NODM的预后因素.结论 胰腺囊性肿瘤行胰体尾切除时应尽可能保留更多的胰腺组织,避免在颈部离断胰腺,BMI≥25.0 和糖尿病家族史的患者术后应密切关注糖代谢情况.

Abstract

Objective To explore the prognostic factors of new-onset diabetes mellitus(NODM)in patients with pancreatic cystic tumor after distal pancreatectomy(DP).Methods Between January 2010 and December 2019,92 patients with cystic pancreatic tumors in our hospital underwent laparoscopic DP.According to the inclusion and exclusion criteria,a total of 74 cases were included and divided into NODM group or normal glucose metabolism group based on whether postoperative NODM occurred.A univariate analysis was used to evaluate the prognostic factors of laparoscopic DP for pancreatic cystic tumors.P<0.05 was considered statistically significant,OR>4 was considered as a potential prognostic factor of clinical significance for NODM.Results NODM was diagnosed in26 cases(35.1%),with a median diagnosis time of 9 months(range,3-56 months)after surgery.Univariate analysis showed that transecting pancreas in the neck(OR = 11.000,P = 0.000),BMI≥25.0(OR = 4.333,P = 0.007),and family history of diabetes mellitus(OR =5.000,P =0.004)were prognostic factors of postoperative NODM.Conclusions When performing DP for pancreatic cystic tumors,it is advisable to preserve as much pancreatic tissue as possible and avoid cutting off the pancreas in the neck.Precise postoperative strategy of glucose metabolism surveillance for patients with BMI≥25.0 and family history of diabetes mellitus should be promoted.

关键词

新发糖尿病/胰腺囊性肿瘤/胰体尾切除

Key words

New-onset diabetes mellitus/Pancreatic cystic tumor/Distal pancreatectomy

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基金项目

北京大学第三医院临床重点项目孵育项目A类(BYSY2018025)

出版年

2024
中国微创外科杂志
北京大学

中国微创外科杂志

CSTPCD北大核心
影响因子:2.21
ISSN:1009-6604
参考文献量13
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