摘要
目的研究肝切除患者术后感染性并发症危险因素及预后营养指数(PNI)联合血清白蛋白(ALB)的预测价值。方法选取2015年2月-2020年4月九江市第一人民医院肝胆外科行肝切除患者100例,依据术后是否出现感染将其分为感染组、非感染组,对比两组临床基线资料、实验室指标检查结果、手术相关指标等,分析导致肝切除患者术后感染性并发症的危险因素,绘制受试者工作特征(ROC)曲线,评估PNI、ALB联合预测术后感染性并发症的价值。结果 100例肝切除患者中25例术后发生感染性并发症,发生率为25.00%(25/100),其中手术皮肤切口感染占24.00%、肺部感染占44.00%、泌尿系统感染占12.00%、腹腔内脓肿占20.00%;年龄、合并糖尿病、PNI、手术时间、术中出血量、术中输血量、术后并发胆瘘、术后引流管留置时间为肝切除患者术后感染性并发症的独立危险因素(P<0.05),而ALB为保护因素(P<0.05);PNI联合ALB检测对肝切除患者术后感染性并发症均有较高预测价值,灵敏度、特异度、曲线下面积分别为0.818、0.824、0.943,均高于PNI、ALB单独检测。结论肝切除患者可能受年龄、糖尿病史、手术时间、术中出血量、术中输血量、术后并发胆瘘、引流管留置时间等因素影响而发生感染性并发症,而PNI、ALB联合检测对感染性并发症有一定预测价值。
OBJECTIVE To investigate the risk factors for postoperative infectious complications in the hepatectomy patients and analyze the predicative value of prognostic nutritional index(PNI) combined with serum albumin(ALB). METHODS Totally 100 patients who underwent hepatectomy in department of hepatobiliary surgery of the First People′s Hospital of Jiujiang between Feb. 2015 and Apr. 2020 were enrolled in the study and were divided into the infection group and the non-infection group according to the status of postoperative infection.The clinical baseline data, laboratory tested indexes and surgical indexes were compared between the two groups, the risk factors for the postoperative infectious complications were analyzed, and the receive operating characteristic(ROC) curve was drawn to evaluate the value of PNI combined with ALB in prediction of postoperative infectious complications. RESULTS Of the 100 hepatectomy patients, 25 had postoperative infectious complications, with the incidence rate 25.00%(25/100), the patients with surgical skin incision infection accounted for 24.00%, the patients with pulmonary infection 44.00%, the patients with urinary system infection 12.00%, the patients with abdominal abscess 20.00%.The independent risk factors for the postoperative infectious complications in the hepatectomy patients included age, complication with diabetes mellitus, serum miR-21, IFITM3, PNI, operation duration, intraoperative blood loss volume, intraoperative blood transfusion volume, postoperative biliary fistula and postoperative indwelling time of drainage tube(P<0.05), while ALB was a protective factor(P<0.05).PNI combined with ALB had high value in prediction of postoperative infectious complications in the hepatectomy patients;the sensitivity was 0.818, the specificity 0.824, the area under curve 0.943, higher than those of the single PNI or ALB. CONCLUSION The age, history of diabetes mellitus, operation duration, intraoperative blood loss volume, intraoperative blood transfusion volume, postoperative b
作者
孙亭立
淦勤
刘合春
SUN Ting-li;GAN Qin;LIU He-chun(The First Peopled Hospital of Jiujiang,Jiujiang,Jiangxi 332000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第2期223-227,共5页
Chinese Journal of Nosocomiology
基金
江西省卫生健康委科技计划基金资助项目(20204224)。
关键词
肝切除
感染性并发症
危险因素
预后营养指数
血清白蛋白
预测价值
Hepatectomy
Infectious complication
Risk factor
Prognostic nutritional index
Serum albumin
Predictive value
