肝内胆管空肠吻合手术严重并发症和病死率的多因素分析  

Postoperative mortality and major complications after hepaticojejunostomy:a multivariate analysis of clinical factors

作　　者：刘建伟 

机构地区：[1]暨南大学附属广州市红十字会医院普通外科,广东广州510220

出　　处：《中国实用外科杂志》2006年第12期960-962,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨肝内胆管空肠吻合术的术后严重并发症及其危险因素。方法回顾性分析1990年1月至2004年8月暨南大学附属广州市红十字会医院163例行肝内胆管空肠吻合术病人的手术死亡和术后严重并发症的情况,并通过单因素分析和多因素分析评价其危险因素。结果住院期间病死率为11·7%(19/163),与手术相关的严重并发症发生率为23·9%(39/163)。Logistic回归分析显示,发生并发症危险因素依次是低蛋白血症、胆肠吻合口过多、病人有心肺合并症或糖尿病和恶性病变,而影响手术死亡率的危险因素是恶性病变、低蛋白血症和心肺合并症或糖尿病。结论术前肝功能不良是肝内胆管空肠吻合术术后并发症最主要的危险因素。手术医生正确掌握相关危险因素,提高手术技能是减少术后并发症的关键。Objective To investigate the postoperative mortality and major complications after hepaticojejunostomy and its relationship with clinical risk factors. Methods The postoperative mortality and major complication incidence of 163 patients underwent hepaticojejunostomy between January 1990 and August 2004 in Guangzhou Red Cross Hospital of Jinan University were analyzed retrospectively. Univariate and multivariate analysis were used to analyze clinical risk factors. Results Postoperative severe complications were observed in 39 patients （23.9%）, dnd 19 patients （ 11.7% ） died of complications. Logistic regression analysis revealed that malignant tumor, hypoalbuminemia and chronic disease were the independently significant factors for operative mortality. Hypoalbuminemia, more anastomotic stoma, chronic disease and malignant tumor were the independently significant factors for postoperative major complications. Conclusion Hypoalbuminernia is the most important risk factor for outcome after hepaticojejunostomy. It＇ s important for surgeons to predominate opportunity and management of patients correctly for reducing postoperative complications.

关 键 词：肝肠吻合 危险因素 LOGISTIC回归分析 

分 类 号：R6[医药卫生—外科学]