肝切除术后并发症危险因素分析  

Risk factors for postoperative morbidity after hepatectomy

作　　者：叶伯根[1] 高登辉[1] 耿小平[2] 熊奇如[2] 

机构地区：[1]安徽医科大学第一附属医院急诊外科,安徽合肥230022 [2]安徽医科大学第一附属医院肝胆外科,安徽合肥230022

出　　处：《安徽医药》2011年第10期1232-1234,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨肝切除术后并发症的有关危险因素。方法回顾性分析100例肝切除患者的临床资料,根据术后有无并发症,分为并发症组和对照组,采用单因素和多因素分析确定肝切除术后并发症的独立危险因素。结果本组因并发症死亡1例,围手术死亡率为1%,15例患者术后出现并发症,发生率为15%,术后并发症包括:腹腔包裹性积液5例(5%)、切口感染5例(5%)、胆漏2例(2%)、术后腹腔出血2例(2%)、肺部感染1例(1%)、肝功能衰竭1例(1%)、胆道损伤1例(1%)、心律失常1例(1%)。单因素分析显示,年龄(P=0.030)、术中出血量(P=0.019)和围手术期输血(P=0.011)等3项指标与术后并发症有关,多因素分析显示,年龄(P=0.048,OR=1.047,95%CI:1.000～1.096)和围手术期输血(P=0.027,OR=4.578,95%CI:1.184～17.698)是肝切除术后并发症的独立危险因素。结论围手术期输血及年龄是肝切除术后并发症的独立危险因素。肝切除术过程中必须尽量减少术中失血,避免围手术输血,对于高龄患者尤为重要。Aim To study the risk factors for postoperative morbidity after hepatectomy.Methods 100 consecutive patients undergoing hepatectomy were investigated retrospectively.They were divided into two groups of development of postoperative complications and control group.Possible risk factors pertaining to the development of complications were identified using univariate and multivariate analyses.Results The surgical mortality was 1%（1/100）.Postoperative complications occurred in 15 of 100 patients（15%）.The morbidity included intra-abdominal collection in 5（5%）,wound infection in 5（5%）,bile leakage in 2（2%）,postoperative intra-abdominal hemorrhage in 2（2%）,pulmonary infection in 1（1%）,hepatic function insufficiency in 1（1%）,bile damage in 1（1%）,arrhythmia in 1（1%）.The univariate analysis identified that age（P=0.030）,the amount of intraoperative blood（P=0.019）and perioperative blood transfusion（P=0.011）were correlated with the complications after hepatoectomy.The multivariate logistic regression analysis identified that age（P =0.048,odds ratio=1.047,95%confidence interval：1.000 to 1.096）and perioperative blood transfusion（P =0.027,odds ratio=4.578,95%confidence interval：1.184 to 17.698）were the independent risk factors for development of complications after hepatoectomy.Conclusion Perioperative blood transfusion and age are the independent risk factors for development of complications after hepatoectomy.We must reduce intraoperative blood loss and avoid perioperative blood transfusion in hepatoectomy,especially for the old age.

关 键 词：肝切除术 并发症 危险因素 

分 类 号：R657.3[医药卫生—外科学]