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原发性肝癌肝切除术后肝功能衰竭的风险因素分析 被引量:13

Risk factors for post hepatectomy liver failure in patients with primary liver cancer
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摘要 目的分析原发性肝癌患者行肝切除术后肝功能衰竭的风险因素。方法回顾性分析赣南医学院第一附属医院肝胆外科2014年1月至2018年12月行肝切除术的原发性肝癌患者临床资料。收集患者性别、年龄等基本信息,Child-Pugh评分和分级、终末期肝病模型评分、肝硬化情况等术前指标,术中出血量、术中输血量及术中肝血流阻断情况等术中指标以及术后病理学结果等术后指标。对肝切除术后肝功能衰竭的相关因素进行单因素分析,将有统计学意义的因素纳入logistic多因素回归分析。结果共纳入89例患者,其中男性76例,女性13例,年龄(54.0±11.3)岁。单因素分析显示Child-Pugh分级和肝硬化为肝切除术后肝功能衰竭的相关风险因素。Child-Pugh A级和B级患者肝切除术后肝功能衰竭发生率分别为25.0%(18/72)、70.6%(12/17),差异具有统计学意义(P<0.05)。肝硬化和无肝硬化患者肝切除术后肝功能衰竭发生率分别为50.0%(20/40)、20.4%(10/49),差异有统计学意义(P<0.05)。多因素logistic回归分析显示Child-Pugh分级(OR=5.698,95%CI:1.694~19.163)、肝硬化(OR=3.074,95%CI:1.147~8.240)为肝切除术后肝功能衰竭的独立风险因素。结论Child-Pugh分级和肝硬化是原发性肝癌患者肝切除术后肝功能衰竭的独立风险因素。 Objective To study the risk factors for post hepatectomy liver failure in patients with primary liver cancer.Methods The clinical data of patients with primary liver cancer who underwent hepatectomy from January 2014 to December 2018 at the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Gannan Medical College were retrospectively analyzed.Basic information on preoperative data including patient gender,age,Child-Pugh score and grading,end-stage liver disease model score and liver cirrhosis;intraoperative data including intraoperative bleeding,intraoperative blood transfusion,and duration of hepatic vascular inflow/outflow occlusion;and postoperative data including postoperative pathological results were collected and analyzed.Univariate analysis was performed on factors related to post hepatectomy liver failure.Statistically significant factors were included in the logistic multivariate regression analysis.Results Complete clinical data were obtained in 89 patients,including 76 males and 13 females,with a Mean±SD age of(54.0±11.3)years.Univariate analysis indicated that Child-Pugh grading and cirrhosis were associated with risk factors for post-hepatectomy liver failure.The incidences of post hepatectomy liver failure for patients with Child-Pugh grade A and B were 25.0%(18/72)and 70.6%(12/17),respectively.The difference was significant(P<0.05).The incidence of post-hepatectomy liver failure patients with cirrhosis and non-cirrhosis were 50.0%(20/40)and 20.4%(10/49),respectively.The difference was significant(P<0.05).Multivariate logistic regression analysis showed that Child-Pugh classification(OR=5.698,95%CI:1.694-19.163)and cirrhosis(OR=3.074,95%CI:1.147-8.240)were independent risk factors for post hepatectomy liver failure.Conclusions Child-Pugh classification and cirrhosis were independent risk factors for post hepatectomy liver failure.
作者 陈斌 胡志强 Chen Bin;Hu Zhiqiang(Department of General Surgery,the First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,Jiangxi Province,China)
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2020年第12期881-885,共5页 Chinese Journal of Hepatobiliary Surgery
关键词 肝切除术 肝功能衰竭 风险因素 Hepatectomy Liver failure Risk factors
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