肝硬化门静脉高压症患者断流术后发生并发症的风险因素分析  

Risk factor analysis of postoperative complications after devascularization in patients with liver cirrhosis and portal hypertension

作　　者：宋兴超[1] 刘胜利[2] 

机构地区：[1]徐州市第一人民医院普外科,江苏徐州221009 [2]东南大学附属中大医院普外科,江苏南京210009

出　　处：《东南大学学报（医学版）》2009年第6期508-511,共4页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:研究肝硬化门静脉高压症患者断流术后发生并发症的风险因素。方法:回顾分析行断流术的肝硬化门静脉高压症患者119例的临床资料,根据术后并发症情况分为有并发症组和无并发症组,将其作为因变量,将16项相关的风险因素作为自变量,进行多因素Logistic回归和受试者工作特征曲线(ROC)分析。结果:单因素分析中,年龄、血小板、血糖、手术耗时、手术时机、食管胃底静脉曲张程度、肝功能分级、术中输血量组间差异有统计学意义。多因素分析中肝功能分级、食管胃底静脉曲张程度、术中输血量为独立的危险因素。ROC分析中曲线下面积(AUC)依次为术中输血量、肝功能分级、食管胃底静脉曲张程度。结论:肝硬化门静脉高压症患者断流术后发生并发症的风险因素为术中输血量、肝功能分级、食管胃底静脉曲张程度。Objective To identify risk factors for devascularization surgery in patients with liver cirrhosis and portal hypertension. Methods The clinical data of 119 patients with liver cirrhosis and portal hypertension receiving devascularization operation were retrospectively analyzed. The patients were divided into two groups according to postoperative complications. Receiver operating characteristic （ROC） and area under the curve（AUC） analyses were performed in different groups for determination of 16 relevant risk factors. Results The univariate analysis showed that age, blood platelet, blood glucose, operative duration, operative timing, degree of preoperative esophagogastic varices, preoperative Child-Pugh classification, and intraoperative transfusion were significantly different between the non-complications group and the complications group. However, only preoperative Child-Pugh classification, degree of preoperative esophagogastic varices and intraoperative transfusion were identified as independent risk factors in the Logistic multivariate analysis, and the values of AUC were decreased in order of intraoperative transfusion 〉 Child-Pugh classification 〉 preoperative esophagogastic varices. Conclusion The risk factors of postoperative complications after devascularization in patients with liver cirrhosis and portal and portal hypertension are intraoperative transfusion, preoperative Child-Pugh classification and preoperative esophagogastic varices.

关 键 词：肝硬化 门静脉高压症 断流术 术后并发症 LOGISTIC回归分析 受试者工作特征曲线 

分 类 号：R575.21[医药卫生—消化系统] R619[医药卫生—内科学]