目的:总结分析国内外压力性损伤指南相关内容,为临床中的压力性损伤临床护理实践提供依据.方法:首先计算机检索与压力性损伤相关的指南,然后使用指南研究与评价工具Ⅱ(AGREEⅡ)对纳入的相关指南进行评价,最后使用GRADE证据分级对证据进行汇总及质量评价.结果:纳入指南8篇,其中质量评价为A级指南4篇,质量评价为B级指南4篇;从病人评估、皮肤保护、敷料选择、体位改变、支撑面、治疗措施和教育培训7个方面总结出20条推荐意见.结论:纳入国内相关指南仅1篇,数量明显少于国外指南;国内研究者偏向于借鉴国外临床指南,而非自主开发相应指南.因此,国内专家需根据临床科研总结制定出符合中国国情的实践指南,为临床护理实践提供参考借鉴.

目的:探讨免疫吸附疗法应用于扩张型心肌病（DCM）患者的有效性和安全性。方法:本研究在国内首次报道免疫吸附疗法成功应用于1例DCM患者，并通过荟萃分析系统性评价免疫吸附疗法在DCM患者中的有效性与安全性。荟萃分析中，我们检索PubMed、Embase、Web of Science-MEDLINE、Cochrane Library、CENTRAL和ClinicalTrials.gov等数据库，查找2000年1月1日—2021年11月26日以英文发表的免疫吸附疗法治疗DCM的临床研究。应用Stata MP Version 15.0和GraphPad Prism Version 7.0软件进行荟萃分析和统计分析。结果:该例DCM患者接受单疗程的免疫吸附治疗后，在18个月随访期间，N末端脑钠肽原下降，左室射血分数增加以及左室舒张末期内径减低。荟萃分析最终纳入11篇文献，包括313例DCM患者，其中免疫吸附组167例，对照组146例，平均随访时间为3～30个月。与对照组相比，免疫吸附组DCM患者NYHA心功能分级得到明显改善（P＜0.000 1）,伴左室射血分数升高（WMD=6.70,95%CI:5.28～8.12）和左室舒张末期内径减低（WMD=-3.65,95%CI:-4.12～-3.19）。免疫吸附组患者未见感染、大出血、肾功能恶化等严重并发症的报道。结论:免疫吸附疗法可明显改善DCM患者的心功能和逆转心脏重构。

目的 分析腹腔镜胰十二指肠切除术(LPD)后发生临床相关胃排空延迟(CR-DGE)的危险因素.方法 回顾性分析2014年7月至2019年12月华中科技大学同济医学院附属同济医院胆胰外科实施LPD的297例病人的临床资料.根据国际胰腺外科研究学组的标准定义,B级和C级胃排空延迟(DGE)被归类为CR-DGE.通过对围手术期临床相关及实验室指标作为独立变量进行单因素和多因素Logistic回归分析,评估LPD术后发生CR-DGE的危险因素.结果 297例病人中有71例(23.9％)术后发生CR-DGE,其中B级45例(15.2％),C级26例(8.7％).单因素分析显示,术前高血清肌酐、术中出血量多、术后胰瘘(B、C级)、术后出血、腹腔感染、胰腺炎和Clavien-Dindo分级≥Ⅲ级是CR-DGE的危险因素(P＜0.05).多因素Logistic回归分析显示,术中出血量多(OR 1.001,95％CI 1.000-1.003,P=0.0088)和腹腔感染(OR 8.017,95％CI 3.644-17.641,P＜0.001)是CR-DGE 的独立危险因素.结论 术中出血量多和腹腔感染是LPD术后发生CR-DGE的独立危险因素,有效地降低术中出血和积极地控制术后腹腔感染有助于降低CR-DGE的发生率.

Objective:To explore the clinical pathological characteristics and initial 131I curative responses of familial differentiated thyroid cancer (FDTC) and sporadic differentiated thyroid cancer (SDTC). Methods:A total of 66 FDTC patients (19 males, 47 females, age (39.8±11.7) years) and 1 701 SDTC patients (442 males, 1 259 females, age (40.9±11.3) years) who underwent 131I therapy in Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2010 and August 2018 were retrospectively enrolled. The clinical pathological characteristics, preablative stimulated thyroglobulin (ps-Tg), preablative stimulated thyroglobulin antibody (ps-TgAb) and response to initial therapy (excellent response, indeterminate response, biochemical incomplete response, structural incomplete response) of two groups were analyzed and compared. The clinical pathological parameters included age, gender, pathological type, tumour maximum diameter, bilateral, multifoci, nodules goiter, thyroiditis, thyroid membrane invasion, lymph node metastasis (LNM), invasion of the surrounding soft tissues, distant metastasis, TNM staging and American Thyroid Association (ATA) risk stratification (low-risk, intermediate-risk, high-risk). χ2 test or Fisher exact test and independent-sample t test were used to compare the data between two groups. Results:Comparing with SDTC group, FDTC group showed higher proportion of bilateral foci (45.5%(30/66) vs 31.2%(530/1 701); χ2=5.999, P=0.010), thyroid membrane invasion (43.9%(29/66) vs 26.6%(452/1 701); χ2=9.672, P=0.002) and distant metastasis (15.2%(10/66) vs 6.2%(105/1 701); χ2=8.418, P=0.004). There was a statistical difference in risk stratification between two groups (high-risk: 18.2%(12/66) vs 9.2%(156/1 701); intermediate-risk: 68.2%(45/66) vs 72.7%(1 237/1 701); low-risk: 13.6%(9/66) vs 18.1%(308/1 701); χ2=6.898, P=0.030). But the tumor maximum diameter of FDTC group was smaller than that of SDTC group ((1.24±0.74) vs (1.50±0.92) cm; t=-2.275, P=0.020). There were no significant differences in other clinical pathological parameters between FDTC group and SDTC group ( t=-0.804, χ2 values: 0.101-5.359, all P>0.05). There were no significant differences between two groups in the postoperation ps-Tg, ps-TgAb levels and the response to initial therapy after 131I treatment ( χ2 values: 0.059-1.915, all P>0.05). Conclusions:The FDTC group displays distinct characteristics as increased aggressiveness at diagnosis. But after accurately treatment, there is no significant difference in the response to therapy between two groups.

胰腺癌是一种临床发现晚、恶性程度高和预后较差的消化系统恶性肿瘤.为了改善病人的预后,探索经济、准确、微创的方法进行早期诊断,以提高手术的可切除率,具有重要的临床意义.液态活检是在可提取的体液标本中检测多种肿瘤相关生物标志物,如循环肿瘤细胞、循环肿瘤DNA和外泌体等.近年来的研究显示,液态活检在胰腺癌早期诊断中发挥着重要的作用.本文就液态活检相关标志物在胰腺癌早期诊断中的优势、局限性以及临床应用前景等方面进行综述.

Objective:To investigate the safety and effectiveness of laparoscopic radical resection of hilar cholangiocarcinoma.Methods:Data of 61 hilar cholangiocarcinom patients operated at Affiliated Tongji Hospital from Jan 2014 to Jul 2019 were analyzed. Ninteen patients underwent laparoscopic surgery (LS) and 42 underwent open surgery (OS). Perioperative complications, pathological characteristics and follow-up results were compared between LS group and OS group.Results:Operation time in LS group was significantly longer than OS group. While, the time of taking food orally was earlier, hospital and ICU stay were shorter than in OA group ( P<0.05). The higher R 0 resection rate, the more harvested lymph nodes and the positive lymph nodes were also observed in LS group than those in OS group ( P<0.05). There were no significant differences in the incidence of postoperative complications and 90-day mortality between the two groups ( P>0.05). Though, the incidence of pulmonary infection in LS group was higher than that in OS group ( P=0.015). Conclusions:Laparoscopic surgery is safe and feasible for hilar cholangiocarcinoma.

当今分子影像技术在疾病的个体化诊疗中起着至关重要的作用.由于每种显像技术都有其自身的局限性,多模态成像已成为当前分子影像领域发展的主流.基于一体化PET/MR成像设备的广泛应用,PET/MR双模态探针由于综合了高分辨率和高灵敏度的优点引起人们的极大关注.本文对PET/MR双模态分子探针的发展现状和应用前景进行综述.

目的:探讨全后腹膜动脉优先入路在全胰十二指肠切除术中的临床应用.方法:回顾分析2014年2月至2020年6月为34例患者行全胰十二指肠切除术的临床资料.结果:34例均成功经全后腹膜动脉优先入路完成全胰十二指肠切除术,手术时间平均(411±116)min,中位术中出血量800 mL(300～1275 mL);术后总体并发症发生率为23.5％(8/34),其中Cla-vienⅢ级及以上并发症发生率为8.8％(3/34),无术后30 d死亡病例.10例行腹腔镜手术,24例行开腹手术,腹腔镜组手术时间、术中出血量、术后并发症发生率均优于开腹组.术后常规病理示胰腺癌24例,其中22例为R0切除,2例为R1切除;根据美国癌症联合委员会第8版胰腺癌TNM临床分期,ⅠA期1例、ⅠB期6例、ⅡA期9例、ⅡB期7例、Ⅲ期1例.33例患者术后获得随访,总体中位生存期26.5个月,胰腺癌组中位生存期15个月.结论:经全后腹膜动脉优先入路行全胰十二指肠切除术安全、可靠,术后生存期虽无明显提高,但术后并发症发生率、病死率明显下降.对于合适的病例,动脉优先入路全胰切除术可作为优选术式.

目的:探讨新型优化康复模式在老年心力衰竭病人中的护理效果及对不良心脏事件发生率的影响.方法:选择老年心力衰竭病人300例作为研究对象,随机分为对照组和观察组各150例.对照组给予常规护理,观察组在对照组基础上联合新型优化康复模式,护理后4周对病人效果进行评估,比较两组心功能水平、不良心脏事件发生率及知晓率.结果:观察组护理后4周左心室收缩末期容积(LVESV)、室壁运动积分指数(WMSI)水平低于对照组(P<0.05);观察组护理后4周左心室舒张末期容积(LVEDV)水平高于对照组(P<0.05);观察组护理后4周心肌梗死、心律失常、心绞痛、再发心力衰竭心脏不良事件发生率低于对照组(P<0.05);观察组护理后4周治疗方法、疾病发展、疾病危害知晓率及护理方法、护理效果及护理内容满意度均高于对照组(P<0.05).结论:新型优化康复模式用于老年心力衰竭病人中能提高病人心功能水平,有助于提高病人相关知识知晓率和对护理工作满意度,降低不良心脏事件发生率.

目的 探究地塞米松治疗重症胰腺炎的效果.方法 120例重症胰腺炎患者,随机分为对照组和研究组,每组60例.对照组患者进行常规治疗,研究组患者在常规治疗的基础上进行地塞米松药物治疗.比较两组患者治疗效果、腹痛腹胀缓解时间、血淀粉酶恢复时间、C-反应蛋白(CRP)恢复时间、住院时间.结果 研究组治疗总有效率90.0%高于对照组的75.0%,差异具有统计学意义(P<0.05).研究组腹痛腹胀缓解、血淀粉酶恢复、CRP恢复、住院时间分别为(4.2±1.2)、(5.3±1.5)、(8.0±1.2)、(14.5±3.5)d,均短于对照组的(6.5±1.8)、(7.0±1.0)、(13.2±0.8)、(17.8±4.5)d,差异具有统计学意义(P<0.05).结论 将地塞米松药物治疗应用于重症胰腺炎的临床治疗中,具有良好效果,较大程度上缩短了腹痛、腹胀缓解时间和血淀粉酶恢复正常时长,CRP恢复正常时间,促进了患者的康复,值得推广应用.

目的 观察丹参酮ⅡA磺酸钠对大鼠肠缺血再灌注(Ⅱ/R)肺损伤的作用及影响机制.方法 2019年1—12月于华中科技大学同济医学院附属同济医院进行实验.将30只健康雄性SD大鼠随机数字表法分为假手术+NS组(Sham组),肠缺血再灌注+NS组(Ⅱ/R组),肠缺血再灌注+丹参酮ⅡA磺酸钠注射液组(TanshinoneⅡA组),每组10只.实验结束后处死大鼠取肺组织及支气管肺泡灌洗液(BALF)标本,观察大鼠肺组织病理学改变;测定各组大鼠肺组织湿/干比(W/D);检测大鼠动脉血PaO2,BALF蛋白浓度及炎性细胞因子IL-1β、IL-6及TNF-α水平;检测大鼠肺组织TLR4及pNF-κB p65蛋白表达.结果 肺组织损伤评分、W/D值比较,Sham组<TanshinoneⅡA组<Ⅱ/R组(F/P=178.368/0.000、223.028/0.000);动脉血PaO2比较,Sham组>TanshinoneⅡA组>Ⅱ/R组(F/P=190.446/0.000);BALF蛋白浓度及BALF炎性细胞因子IL-1β、IL-6及TNF-α水平比较,Sham组<TanshinoneⅡA组<Ⅱ/R组(F/P=450.405/0.000、234.850/0.000、1679.317/0.000、543.886/0.000);肺组织TLR4及pNF-κB p65蛋白表达比较,Sham组<TanshinoneⅡA组<Ⅱ/R组(F/P=1434.247/0.000、334.075/0.000).结论 丹参酮ⅡA磺酸钠对Ⅱ/R所致肺损伤具有明显的保护作用,其保护作用可能与抑制TLR4/NF-κB的活化进而抑制肺部炎性反应有关.

目的 分析肝门部胆管癌病人长链非编码RNA(LncRNA)SNHG1表达水平及其与临床特征的相关性.方法 肝门部胆管癌病人36例,利用实时定量PCR检测其肿瘤及对应癌旁组织中LncRNA SNHG1表达水平,根据其表达水平分为高表达与低表达组,分析影响LncRNA SNHG1表达水平的因素及其与病人生存期的关系.结果 36例肝门部胆管癌肿瘤组织中Ln-cRNA SNHG1表达水平高于癌旁组织,差异有统计学意义(P<0.05).淋巴结转移是LncRNA SNHG1表达水平的影响因素,淋巴结转移的病人LncRNA SNHG1低表达组比率高于高表达组(P<0.05).年龄、血浆CA19-9表达水平和LncRNA SNHG1表达水平均是影响胆管癌病人预后的独立因素(P<0.05).结论 LncRNA SNHG1表达水平与肝门部胆管癌转移有一定相关性,可作为判断胆管癌病人预后的独立危险因素,也可作为肝门部胆管癌综合治疗的潜质靶点.

Objective:To detect the role of Long anti-differentiation noncoding RNA (lncRNA ANCR) in human cholangiocarcinoma and explore its effect on apoptosis and invasion ability of cholangiocarcinoma.Methods:We detected the expression of ANCR in human cholangiocarcinoma tissues, normal bile duct tissues by PCR. And we detected invasion and migration ability of human cholangiocarcinoma cell line TFK-1 by Transwell assay and Wound Healing after ANCR lentivirus transfection.And we detected metastasis ability of TFK-1 by building a BALB/c nude mice metastasis model. Two-tailed Student’s t-test was used to evaluate the differences between two groups. All statistical analyses were performed using SPSS 20.0. Results:The expression of ANCR in human cholangiocarcinoma tissues is significantly higher than the normal bile duct tissues [(6.78±5.06) times, t=2.702, P<0.05]; The invasion and migration ability of TFK-1 is declined after ANCR-down lentivirus transfection (256.00±20.53 vs. 952.00±74.47, t=-16.789, P<0.05). The invasion and migration ability of TFK-1 is improving after ANCR-up lentivirus transfection (2 180.00±124.83 vs. 952.00±74.47, t=16.255, P<0.05). The metastasis ability of TFK-1 is declined after ANCR-down lentivirus transfection [(29.00±2.58)% vs. (49.00±3.87)%, t=-12.766, P<0.01]. The metastasis ability of TFK-1 is improving after ANCR-up lentivirus transfection [(86.00±3.06)% vs. (49.00±3.87)%, t=8.416, P<0.01]. ANCR-up cells had formed larger tumors compared with those in control groups [the 5th week, (21.0±2.76) mm vs. (14.8±0.75) mm, t=13.426, P<0.05; the 6th week, (23.8±3.54) mm vs. (16.6±1.74) mm, t=7.561, P<0.05]. The weight of ANCR-up group is reduced than those in the negative control group [the 5th week, (14.56±0.61) g vs. (17.33±0.84) g, t=-2.724, P<0.05; the 6th week, (14.21±0.40) g vs. (17.98±0.43) g, t=-4.795, P<0.05] ANCR-down cells had formed smaller tumors compared with those in control groups [the 5th week, (4.40±1.36) mm vs. (14.8±0.75) mm, t=-7.589, P<0.05; the 6th week, (6.40±2.06) mm vs. (16.6±1.74) mm, t=-4.491, P<0.05]. The weight of ANCR-down group is increased than those in the negative control group [the 5th week, (20.62±1.68) g vs. (17.33±0.84) g, t=3.759, P<0.05; the 6th week, (21.48±1.33) g vs. (17.98±0.43) g, t=8.154, P<0.05]. Conclusion:These results indicate that the expression of ANCR is different between cholangiocarcinoma and normal bile duct tissues and the ANCR probably involved in cholangiocarcinoma invasion, migration and metastasis and are the indicator of diagnosis and prognosis of the cholangiocarcinoma.

介绍容量管理方法在心衰患者治疗,护理方面的研究进展.对饮食管理,体重管理,利尿剂使用,血液超滤4个方面进行综述,总结容量管理方法存在的问题及展望,旨在为医护人员对心衰患者的评估及治疗提供参考.

OBJECTIVE:To study the clinical features of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS:A retrospective analysis was performed for the clinical data of 115 children who were diagnosed with SARS-CoV-2 infection in the Wuhan Children's Hospital, including general information, history of close contact with individuals of SARS-CoV-2 infection, early clinical symptoms, laboratory examination results, and lung CT results. RESULTS:Among the 115 children, there were 73 boys (63.5%) and 42 girls (36.5%), with a male/female ratio of 1:0.58. Of the 115 children, 105 (91.3%) had a definite history of close contact with individuals of SARS-CoV-2-infection. An increase in alanine aminotransferase was observed in 11 children (9.6%) and an increase in CK-MB was found in 34 children (29.6%). As for clinical symptoms, 29 children (25.2%) had fever, 47 (40.9%) had respiratory symptoms (including cough, rhinorrhea, and nasal congestion), and 61 (53.0%) were asymptomatic. Lung CT findings showed ground glass opacity, fiber opacities, patchy changes, and pulmonary consolidation in 49 children (42.6%), among whom 2 children had "white lung"; 39 children (33.9%) only had lung texture enhancement and 27 children (23.5%) had no pulmonary imaging changes. Among the 115 children, 3 were critically ill, among whom 1 had been cured and the other 2 were under continuous treatment. CONCLUSIONS:Most of the children with SARS-CoV-2 infection have a close contact history. Critical cases are rare and there is a high proportion of asymptomatic infection.

目的:探讨长链非编码RNA(lncRNA)FEZF1-AS1调控微小RNA-363-3p(miR-363-3p)影响脂多糖(LPS)诱导的血管内皮细胞活力及凋亡的作用机制.方法:体外培养人脐静脉血管内皮细胞(HUVECs),分别将pcDNA-NC、pcDNA-FEZF1-AS1、anti-miR-NC、anti-miR-363-3p、miR-NC及miR-363-3p mimics转染至HUVECs,并给予LPS刺激24 h;采用RT-qPCR检测FEZF1-AS1和miR-363-3p的表达量;MTT法检测细胞活力;流式细胞术检测细胞凋亡率;双萤光素酶报告基因实验验证FEZF1-AS1与miR-363-3p的靶向调控作用;Western blot法检测细胞周期蛋白D1(cyclin D1)、cleaved caspase-3和Ki67的表达量.结果:与control组比较,LPS组FEZF1-AS1的表达水平显著降低(P<0.05),miR-363-3p的表达水平显著升高(P<0.05);与pcDNA-NC+LPS组比较,pcDNA-FEZF1-AS1+LPS组细胞存活率显著升高(P<0.05),细胞凋亡率显著降低(P<0.05),cyclin D1和Ki67蛋白水平显著升高(P<0.05),cleaved caspase-3蛋白水平显著降低(P<0.05);与anti-miR-NC+LPS组比较,anti-miR-363-3p+LPS组细胞存活率显著升高(P<0.05),细胞凋亡率显著降低(P<0.05),cyclin D1和Ki67蛋白水平显著升高(P<0.05),cleaved caspase-3蛋白水平显著降低(P<0.05);双萤光素酶报告基因实验证实FEZF1-AS1可靶向结合miR-363-3p;与miR-NC+pcD?NA-FEZF1-AS1+LPS组比较,miR-363-3p+pcDNA-FEZF1-AS1+LPS组细胞存活率显著降低(P<0.05),细胞凋亡率显著升高(P<0.05),cyclin D1和Ki67蛋白水平显著降低(P<0.05),cleaved caspase-3蛋白水平显著升高(P<0.05).结论:过表达FEZF1-AS1可抑制miR-363-3p表达从而降低LPS诱导的血管内皮细胞凋亡率,增加其细胞活力.

目的 观察姜黄消瘤汤联合化疗对神经胶质瘤患者术后的临床疗效.方法 60例神经胶质瘤患者随机分为治疗组和对照组各30例.对照组术后给予化疗干预,治疗组在对照组的基础上给予姜黄消瘤汤联合治疗,均以28d为1个疗程,连续治疗4个疗程.观察两组治疗前后近期临床疗效、血清肿瘤抑制蛋白53(p53)、血管内皮生长因子(VGEF)水平、中医证候积分、毒副反应情况.结果 治疗组近期临床疗效和疾病控制方面优于对照组(P＜0.05);治疗后两组中医证候积分、血清p53、VGEF水平较治疗前下降(P＜0.05),治疗组降低程度高于对照组(P＜0.05);治疗组发生胃肠道反应、骨髓抑制、深静脉血栓形成的病例均少于对照组(P＜0.05).结论 姜黄消瘤汤联合化疗对神经胶质瘤患者术后疗效明确,改善中医症状,下调血清p53、VGEF水平,并具有增效减毒作用.

胰十二指肠切除术(pancreaticoduodenectomy, PD)是治疗胆总管下段、胰头部及壶腹周围病变的标准术式. 其切除脏器种类多、操作难度大及消化道重建复杂,且术后并发症发生率较高,是腹部外科具有挑战性的手术之一.Gagner和Pomp于1994年首次报道腹腔镜胰十二指肠切除术(laparoscopic pancreaticoduodenectomy,LPD),但因其手术时间超长,术后并发症发生率和病死率高,而住院时间与费用并未降低,令大多数胰腺外科医师望而却步[1].2008年以来, 随着腹腔镜手术器械及操作技术水平的进步,LPD的安全性与可行性逐步得到众多学者的认可,目前已成为国内、外大型胰腺外科医疗中心常规开展的术式[2]. 近年来的回顾性临床研究表明,LPD具有出血少、术后恢复快等优点,且术后并发症发生率、病死率及肿瘤学治疗效果等方面与传统开腹手术相近,甚至更优[3-8]. 但由于LPD操作过程复杂、技术难度高、学习曲线长等特点,其是否优于开腹胰十二指肠切除术(open pancreaticoduo-denectomy,OPD),尚需前瞻性大样本多中心的临床随机对照研究进一步验证.笔者团队自2014年7月成功开展LPD, 至2018年7月, 共成功实施超过500例. 本文将结合文献及笔者团队的经验,探讨LPD的经验技巧与疗效评价.

目的:评价腹腔镜胰十二指肠切除术(LPD)与开腹胰十二指肠切除术(OPD)近期临床疗效.方法:采用回顾性队列研究方法.收集2017年6月至2018年6月我科收治的120例LPD及同期137例OPD病人临床资料,比较两组在围术期的近期临床疗效.结果:全部257例均顺利完成手术.两组一般资料及术前资料差异均无统计学意义(P>0.05).相比OPD组,LPD组术中出血量少(P<0.001),术后病理切缘阳性率低(P<0.05),LPD组严重并发症(Clavien-Dindo分级≥3)发生率和术后出血、腹腔感染、胃排空障碍发生率低于OPD组(P<0.05),其他相关并发症发生率差异无统计学意义(P>0.05).术后住院时间及术后镇痛时间,LPD组低于OPD组,两组差异具有统计学意义(P<0.001).结论:对于熟练掌握LPD并度过学习曲线的团队,LPD围术期近期临床疗效评价与OPD相当,术中出血量、术后并发症发生等较OPD减少.

Objective: To semi-quantify the postoperative complications occurred after laparoscopic pancreaticoduodenectomy(LPD) using Clavien-Dindo score, thereafter exploring its impact factors. Methods: In this retrospective cohort study, the clinical data of 124 patients who had undergone LPD for periampullary tumor from June 2016 to June 2017 at Department of Biliary Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were collected.Malignancy was confirmed based on postoperative pathological reports.Postoperative complications were semi-quantitated using Clavien-Dindo score.Multivariable logistic regression model was applied to explore the factors related to severe complications(Clavien-Dindo Ⅲb-Ⅴ). Results: Of the 124 patients, there were 64 males(51.6%) and 60 females(48.4%), with age of 57 years(range, 23-82 years). In total, postoperative complications occurred in 30 patients(24.2%). Among the 30 patients, 4 patients suffered Clavien-Dindo grade Ⅰ, 18 patients(14.5%) suffered Clavien-Dindo grade Ⅱ, 6 patients(4.8%) suffered Clavien-Dindo grade Ⅲa, 1 patient(0.1%) suffered Clavien-Dindo grade Ⅳb, and 1 patient(0.1%) suffered Clavien-Dindo grade Ⅴ.Intraabdominal hemorrhage occurred in 8 patients, pancreatic fistula was found in 10 patients(7 patients had biochemical leakage and 3 of them had grade B pancreatic fistula), both biliary fistula and gastrointestinal fistula were found in 1 patient.Abdominal infection occurred in 10 patients, both liver failure and renal failure occurred in one patient.Moreover, arrhythmia was found in two patients, and mortality occurred in one patient.Five patients suffered multiple complications.Univariable analysis showed that postoperative complications were associated with body mass index, American Society of Anesthesiologists(ASA) score, intraoperative blood transfusion, and pancreatic texture(P<0.05). In multivariable logistic regression, ASA grade Ⅲ, intraoperative blood transfusion, and pancreatic softness were independently related to postoperative complications after LPD(P<0.05). Conclusions: Clavien-Dindo score is feasible to be applied in management of patients with LPD.ASA score, texture of pancreas, and intraoperative blood transfusion were independently associated with postoperative complications.