乙肝后肝硬化门脉高压症脾切除门奇断流术后预后影响因素分析  

ANALYSIS OF PROGNOSTIC FACTORS IN PATIENTS AFTER SPLENECTOMY AND PORTAL AZYGOUS DISCONNECTION FOR PORTAL HYPERTENSION DUE TO CIRRHOSIS RESULT FROM HEPATITIS B

作　　者：陈平[1] 王胜利[1] 姜海涛[1] 

机构地区：[1]六安市中医院普外科,六安237006

出　　处：《肝胆外科杂志》2011年第6期431-434,共4页Journal of Hepatobiliary Surgery

摘　　要：目的总结影响脾切除门奇断流术后预后的主要风险因素。方法选择具有完整临床资料和成功随访到的186例乙肝后肝硬化门脉高压患者进行回顾性分析,采用Kaplain-Meier法及Log-rank检验对32项指标进行单因素分析;将单因素分析有意义的指标采用Cox回归模型进行多因素分析,筛选出影响预后的主要因素。结果多因素分析显示以下7项指标与外科治疗乙肝后肝硬化门脉高压患者预后有显著相关性:肝硬化分级、术后并发症、CrCTP评分(包含肌酐的CTP评分)、术前食管胃底曲张静脉破裂出血史、合并其他脏器基础疾病、术后肝炎活动及治疗依从性(P=0.000～0.023)。结论肝硬化分级、术后并发症、CrCTP评分、术前食管胃底曲张静脉破裂出血史、合并其他脏器基础疾病、术后肝炎活动及治疗依从性是影响肝硬化门脉高压术后预后的重要因素,可作为评估预后的参考指标。Objective To study the factors influencing the prognosis of patients after splenectomy and portal azygous disconnection for portal hypertension due to cirrhosis result from hepatitis b.Methods 186 patients with portal hypertension due to cirrhosis result from hepatitis b were retrospectively studied and followed up 32 indicators were observed.Univariate analysis of the 32 indicators were performed by Kaplain-Meier method and Log-rank test,then using the Cox proportional hazard regression to analyze the meaningful result derived from univariate analysis for filtering out the significantly prognostic factors.Results According to the multivariate Cox proportional hazard regression analysis,the factors that had significant influence on the prognosis of hepatic cirrhosis patients included： severity of hepatic cirrhosis,postoperative complications,CrCTP score,esophageal varices bleeding history,combined with other organ-based diseases,hepatitis of exacerbation,hepatitis,treatment compliance（Sig=0.000～0.023）.Conclusions The factors that had significant influence on the prognosis of hepatic cirrhosis patients included： severity of hepatic cirrhosis,postoperative complications,CrCTP score,esophageal varices bleeding history,combined with other organ-based diseases,exacerbation of hepatitis,treatment compliance.These indicators might be included in a model to predict the prognosis of hepatic cirrhosispatients.

关 键 词：乙型肝炎 肝硬化 门脉高压症 预后 生存分析 治疗依从性 

分 类 号：R575[医药卫生—消化系统]