摘要
目的分析影响肝癌破裂出血患者预后生存期的危险因素。方法回顾性分析185例肝癌破裂出血患者临床资料。记录其术后3年生存情况,并使用Kaplan-Meier法绘制生存曲线。采用Log-rank检验行肝癌破裂出血患者预后生存期的单因素分析,多因素分析使用COX回归模型。结果185例肝癌破裂出血患者术后3年存活131例(70.81%),死亡54例(29.19%);经Kaplan-Meier法分析,发现肝癌破裂出血患者术后3年平均生存期为31.54个月。经Log-rank检验,发现性别、年龄与肝癌破裂出血患者预后生存期无明显相关性(P>0.05),而肝功能分级(Child-Pugh分级)不佳、肝硬化严重、肿瘤直径大、行二期手术治疗、手术时间长、术中输血量大者预后生存期短(P<0.05)。多因素COX回归分析显示,Child-Pugh分级不佳、肝硬化严重、肿瘤直径大、二期手术、手术时间长、术中输血量大是影响肝癌破裂出血患者预后生存期的独立危险因素(RR=2.038、3.065、2.002、1.917、2.273、2.680,P<0.05)。结论肝癌破裂出血患者预后生存期与肝功能分级、肝硬化情况、肿瘤大小、治疗方式、手术时间及术中输血量等均相关,临床应制定针对性防控措施,以改善患者预后。
Objective To analyze the risk factors affecting the prognosis survival time of patients with rupture and hemorrhage of hepatocellular carcinoma.Methods The clinical data of 185 patients with rupture and hemorrhage of hepatocellular carcinoma were retrospectively analyzed.The survival status at 3 years after operation was recorded,and the survival curve was plotted using the Kaplan-Meier method.Univariate analysis of prognosis survival time in patients with rupture and hemorrhage of hepatocellular carcinoma was performed by using Log-rank test,and multivariate analysis was performed by using COX regression model.Results Among 185 patients with rupture and hemorrhage of hepatocellular carcinoma,there were 131 cases(131.81%)of survival and 54 cases(29.19%)of death at 3 years after operation.Kaplan-Meier analysis showed that the average survival time of patients with rupture and hemorrhage of hepatocellular carcinoma was 31.54 months at 3 years after operation.Log-rank test showed that there was no significant correlation between gender and age and prognosis survival time of patients with rupture and hemorrhage of hepatocellular carcinoma(P>0.05),but the prognosis survival time was shorter in patients with poor liver function grading(Child-Pugh grading),severe cirrhosis,large tumor diameter,second-stage surgery,long operative time and high intraoperative blood transfusion(P<0.05).Multivariate COX regression analysis showed that poor Child-Pugh grading,severe cirrhosis,large tumor diameter,second-stage surgery,long operative time and high intraoperative blood transfusion were independent risk factors for prognosis survival time of patients with rupture and hemorrhage of hepatocellular carcinoma(RR=2.038,3.065,2.002,1.917,2.273,2.680,P<0.05).Conclusion The prognosis survival time of patients with rupture and hemorrhage of hepatocellular carcinoma is related to liver function grading,cirrhosis,tumor size,treatment modes,operative time and intraoperative blood transfusion.It is necessary to develop targeted prevention an
作者
尹袁英
刘伟
张铭光
YIN Yuanying;LIU Wei;ZHANG Mingguang(West China Hospital,Sichuan University,Chengdu,610041)
出处
《实用癌症杂志》
2020年第9期1508-1511,共4页
The Practical Journal of Cancer
关键词
肝癌破裂出血
预后
生存时间
生存曲线
Rupture and hemorrhage of hepatocellular carcinoma
Prognosis
Survival time
Survival curve
