摘要
目的探讨肝门部胆管癌(HCCA)患者行大范围肝切除术(MLR)术后并发症发生的相关影响因素,为临床防治策略制定提供依据。方法回顾性分析行MLR治疗的94例HCCA患者临床资料,依据术后是否发生并发症分为并发症组及无并发症组,统计2组性别、年龄、体质量指数、术前Bismuth分型等临床资料,先进行单因素分析,之后将具有统计学差异的变量纳入多因素Logistic回归模型,采用逐步回归筛选变量,最终获取HCCA行MLR术后并发症发生的独立影响因素。结果94例HCCA患者手术治疗后39例出现并发症,分别为13例肝功能不全、10例腹腔感染、8例胆肠漏、6例腹腔出血、2例肺部感染,术后并发症发生率为41.49%(39/94)。2组年龄、Bismuth分型、术前胆红素水平、术中大出血、术前血清白蛋白水平相比,差异有统计学意义(P<0.05);多因素分析显示:年龄、Bismuth分型、术前胆红素水平、术中大出血、术前血清白蛋白水平是影响HCCA行MLR术后发生并发症的高危因素(P<0.05,且OR>1)。结论HCCA患者MLR术后存在较高并发症风险,与患者年龄、术前Bismuth分型、胆红素水平、血清白蛋白水平等关系密切,临床应针对性做好预防措施,以减少术后并发症发生。
Objective To explore the related factors of postoperative complications of large-scale hepatectomy(MLR)for hilar cholangiocarcinoma(HCCA),and to provide basis for the formulation of clinical prevention and treatment strategies.Methods Clinical data of 94 patients with HCCA treated with MLR were analyzed retrospectively.They were divided into complication group and no complication group according to whether there were postoperative complications.The clinical data of gender,age,body mass index and preoperative bismuth classification of the 2 groups were counted.Univariate analysis was performed first,and then the variables with statistical differences were included in the multivariate logistic regression model,Stepwise regression was used to screen variables,and finally obtain the independent influencing factors of complications after MLR in HCCA.Results 39 of 94 patients with HCCA had complications after surgical treatment,including 13 cases of liver dysfunction,10 cases of abdominal infection,8 cases of biliary intestinal leakage,6 cases of abdominal bleeding and 2 cases of pulmonary infection.The incidence of postoperative complications was 41.49%(39/94).There were significant differences in age,bismuth classification,preoperative bilirubin level,intraoperative massive hemorrhage and preoperative serum albumin level between the 2 groups(P<0.05);Multivariate analysis showed that age,bismuth classification,preoperative bilirubin level,intraoperative massive hemorrhage and preoperative serum albumin level were high risk factors for complications after MLR for HCCA(P<0.05,and or>1).Conclusion There is a high risk of complications after MLR in patients with HCCA,which is closely related to the patient's age,preoperative bismuth classification,bilirubin level and serum albumin level.Clinical preventive measures should be taken to reduce the incidence of postoperative complications.
作者
李馨
梁亚丽
李慧
董赛男
LI Xin;LIANG Yali;LI Hui(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)
出处
《实用癌症杂志》
2022年第3期458-460,共3页
The Practical Journal of Cancer
关键词
肝门部胆管癌
大范围肝切除术
术后并发症
影响因素
Hilar cholangiocarcinoma
Extensive hepatectomy
Postoperative complications
Influence factor
