摘要
目的研究乙型肝炎相关肝硬化肝癌与无肝硬化肝癌患者围术期情况及肝癌患者术后发生肝衰竭的危险因素。方法采用回顾性研究方法,收集入住我院行肝癌切除术的乙型肝炎肝癌患者160例,其中合并肝硬化90例为研究组,无合并肝硬化患者70例为对照组。比较2组术中及术后情况,对肝癌患者术后发生肝衰竭的危险因素进行分析。结果与对照组比较,研究组术中出血量多、手术时间长,差异有统计学意义(P<0.05);2组术中输血率和肝门阻断率差异无统计学意义(P>0.05)。2组围手术期并发症肺部感染、腹腔感染、胆瘘和肝衰竭发生率差异均无统计学意义(P>0.05)。以是否发生肝衰竭为因变量,以性别、年龄、白蛋白、天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素、血小板、凝血酶原活动度、Child-Pugh分级、手术时间、术中出血量、输血、肝脏切除范围、肿瘤直径、肝门阻断、肝硬化为自变量进行多因素Logistic回归分析,结果显示年龄、Child-Pugh分级、术中出血量、输血、肝脏切除范围、肝硬化为乙型肝炎肝癌患者围手术期发生肝衰竭的危险因素。结论肝硬化为乙型肝炎肝癌患者围手术期发生肝衰竭的独立危险因素,合并肝硬化的肝癌患者较无肝硬化肝癌患者出现围手术期肝衰竭的风险高。
Objective To investigate the perioperative condition and risk factors of liver failure in patients with hepatitis B virus-associated liver cancer with or without liver cirrhosis.Methods Retrospective study was used to collect 160 cases of HBCC patients hospitalized in our hospital,including 90 cases of liver cirrhosis and 70 cases without cirrhosis.The intraoperative and postoperative conditions of the 2 groups were compared,and the risk factors for postoperative liver failure were analyzed.Results Compared with the control group,the amount of bleeding was more in the study group and the operation time was longer,the difference was statistically significant（P〈0.05）.The blood transfusion rate and the occlusion rate of the hepatic portal in the study group were slightly higher,but the difference was not statistically significant（P〉0.05）.There was no significant difference in the incidence of perioperative pulmonary complications,abdominal infection,biliary fistula and liver failure between the 2 groups（P〉0.05）.Liver failure is a dependent variable,while sex,age,albumin,aspartate aminotransferase,alanine aminotransferase,total bilirubin,prothrombin time activity,ChildPugh classification,operation time,intraoperative bleeding,blood transfusion,liver resection range,tumor diameter,hepatic portal blockage,cirrhosis being independent variables were analyzed by multiple factor Logistic regression analysis.The results showed that age,Child-Pugh classification,intraoperative bleeding,blood transfusion,liver resection were found.Risk factors for liver failure in patients with hepatitis B and liver cancer during perioperative period were excluded.Conclusion Liver failure is an independent risk factor for liver failure during the perioperative period of liver cirrhosis in patients with hepatitis B,and the risk of peri-operative liver failure in patients with liver cancer and liver cirrhosis is higher than that of patients without liver cirrhosis.
作者
陈锐俊
薛梅
高燕灵
李楚云
CHEN Rui jun;XUE Mei;GAO Yan ling;LI Chu yun(Department of Pharmacy,Huizhou Central People＇s Hospital,Guangdong Provinzce,Huizhou 516000,China)
出处
《河北医科大学学报》
CAS
2018年第6期640-644,共5页
Journal of Hebei Medical University
关键词
肝硬化
肝肿瘤
肝功能衰竭
急性
危险因素
liver cirrhosis
liver neoplasms
liver failure,acute
risk factors
