肝癌切除患者术后并发症原因分析及对策.docVIP

肝癌切除患者术后并发症原因分析及对策【摘要】 目的 分析肝癌切除术后影响并发症出现的危险因素。方法 对110名肝癌切除患者术后出现的并发症进行回顾性总结,选取11个可能因素,分别进行单因素及logistics分析,分析各因素与术后并发症之间的关系。结果 110例肝癌切除患者,术后出现并发症38例(34.5%),对可能影响并发症的各因素行单因素统计分析,结果表明,术前HBVDNA水平、术前Child分级、前白蛋白水平、PT情况、肝门阻断与否、术中出血量等6个因素和术后出现并发症有显著相关,而年龄、性别、有无附加手术、有无基础疾病、BMI等因素则和术后出现主要并发症无明显相关。将上述单因素分析中与术后并发症显著相关的6个因素再进行logistic多因素回归分析,结果表明术前Child分级、前白蛋白水平、术中出血量是术后出现主要并发症的独立危险因素。结论 肝癌手术的并发症情况主要受术前肝功能储备情况及术中出血量等因素影响。 【关键词】 肝癌;并发症 Multivariate regression analysis of factors influencing complications after liver resection for hepatocellular carcinoma HUANG Chang-shan,YU wei,WANG Yun-jian,et al.Department of Hepatobiliary Pancreatic Surgery,Henan Tumor Hospital,Zhengzhou 450008,China 【Abstract】 Objective To analysis of risk factors influencing complications after liver resection for hepatocellular carcinoma.Methods The clinical data of 110 hepatocellular carcinoma cases who underwent liver resection were retrospectly analyzed by univariate and multivariate analyses.Results There were 38 patients(34.5%)represented main complications after operation.Singlevaraite analysis showed that thelevel of HBVDNAand Prealbumin,Child stage,prothrombin time,the hepatic vascular inflow occlusion,total blood loss were proved to be risk factors for complications after liver resection for hepatocellular carcinoma;Multivariate logistic analysis showed that the level of Prealbumin,Child stage and total blood loss were the independent risk factors.Conclusion Preoperation liver function and total blood loss during the operation are the main factors influencing complications after liver resection for hepatocellular carcinoma. 【Key words】 Hepatic carcinoma; Complication 近年来,原发性肝癌的手术效果取得长足进步,死亡率也大幅下降,但是术后并发症仍是困扰临床医生的主要问题之一,国内外报道肝癌切除手术后的并发症发生率仍高达20%~50%[1]。现对我院2007年12月至2009年12月期间行肝癌手术切除患者110例进行总结,分析肝癌切除术后并发症的可能原因及对策,为以后的临床工作提供参考。 1 资料及方法 1.1 一般资料 选取我院2007年12月至2009年12月之间因原发性肝癌行肝脏切除患者110例,其中男83例,女 27例;年龄为31~72岁,其中年龄大于60岁者23例,小于60岁者87例,平均年龄为46.7岁;术前肝功能Child-Pugh A级为94例,Child-P