摘要
目的探讨肝内胆管结石(IHS)患者行肝部分切除术(PH)后并发症的影响因素。方法回顾性分析2015年1月~2019年3月江西省九江市第一人民医院收治的50例行PH治疗的IHS患者的临床资料,根据术后并发症发生情况将其分为并发症组(17例)和无并发症组(33例),收集可能影响IHS患者PH术后并发症发生的相关因素,包括性别、年龄、结石大小、结石类型、IHS部位、手术时间、既往胆道手术史、肝切除范围、术中肝门阻断次数、术前及术后是否加强肺功能锻炼等,应用单因素分析和Logistic多元回归分析影响IHS患者PH术后并发症发生的因素。结果单因素分析结果显示,并发症组患者与无并发症组患者的手术时间、既往胆道手术史、肝切除范围和术前及术后是否加强肺功能锻炼比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,手术时间≥300 min(β=0.516,OR=1.675,95%CI=0.646~4.343)、有既往胆道手术史(β=0.311,OR=1.365,95%CI=0.458~4.063)、术前及术后未加强肺功能锻炼(β=0.478,OR=1.613,95%CI=0.610~4.267)是影响术后并发症发生的独立危险因素(P<0.05)。结论手术时间≥300min、有既往胆道手术史、术前及术后未加强肺功能锻炼是IHS患者行PH治疗术后并发症发生的独立危险因素。
Objective To investigate the influence factors of complications in patients with intrahepatic stones(IHS)after partial hepatectomy(PH).Methods Clinical data of 50 IHS patients who underwent PH and were admitted to the First People's Hospital of Jiujiang City from January 2015 to March 2019 were retrospectively analyzed.According to postoperative complications,they were divided into complication group(17 cases)and non-complication group(33 cases).The related factors that might affect the occurrence of complications in IHS patients after PH were collected,including gender,age,stones size,stones types,IHS sites,operation time,previous history of biliary tract surgery,range of hepatectomy,times of intraoperative hepatic hilar blockage,and strengthening pulmonary function exercise before and after surgery.The influence factors of complications in IHS patients after PH were analyzed by univariate analysis and Logistic multivariate regression analysis.Results The results of univariate analysis showed that there were statistically significant differences in operation time,previous history of biliary tract surgery,hepatectomy range and strengthening pulmonary function exercise before and after surgery between complication group and non-complication group(P<0.05).The results of Logistic multivariate regression analysis showed that operation time≥300 min(β=0.516,OR=1.675,95%CI=0.646-4.343),previous history of biliary tract surgery(β=0.311,OR=1.365,95%CI=0.458-4.063)and not strengthening pulmonary function exercise before and after surgery(β=0.478,OR=1.613,95%CI=0.610-4.267)were independent risk factors of postoperative complications(P<0.05).Conclusion The operation time≥300 min,previous history of biliary tract surgery and not strengthening pulmonary function exercise before and after surgery were independent risk factors of postoperative complications in IHS patients after PH.
作者
孙亭立
淦勤
刘合春
SUN Ting-li;GAN Qin;LIU He-chun(Department of Hepatobiliary Surgery,the First People's Hospital of Jiujiang City,Jiangxi Province,Jiujiang332000,China)
出处
《中国当代医药》
2020年第35期104-107,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(20204224)。
关键词
肝内胆管结石
肝部分切除术
并发症
影响因素
Intrahepatic stones
Partial hepatectomy
Complications
Influence factors
