肝癌切除同时行脾切除加断流术术后并发症的相关因素分析  

Relevant factors of postoperative complications for hepatectomy combined with splenectomy

作　　者：胡亮[1] 易永祥[1] 丁海[1] 韩建波[1] 刘涛[1] 赵亮[1] 

机构地区：[1]东南大学附属第二医院普通外科,南京210003

出　　处：《山东大学学报（医学版）》2013年第1期64-66,共3页Journal of Shandong University:Health Sciences

摘　　要：目的分析行肝癌切除术联合脾脏切除术患者的术后并发症发生的危险因素。方法回顾68例因肝癌及门静脉高压行肝癌切除术联合脾脏切除术患者,统计学分析术后并发症发生率的相关因素。结果术后并发症发生率为32.4%(22/68)。并发症主要有:脾窝及胸腔积液、脾窝及胸腔积液感染、胆漏等。术后并发症发生率与年龄、性别、甲胎蛋白、HBV-DNA病毒定量以及肿瘤部位统计学无相关性(P>0.05)。术后并发症发生率与肿瘤大小、肝脏功能Child-pugh分级以及慢性肝炎严重程度呈正相关(P<0.05)。肿瘤越大、肝脏功能越差以及慢性肝炎越严重,肝癌患者术后并发症发生率越高。结论术前及术后加强围手术期处理,改善肝脏功能,提高肝脏功能储备,可减少肝癌切除合并脾脏切除术术后并发症的发生。Objective To analyze the relevant factors of postoperative complications for hepatectomy combined with splenectomy. Methods 68 patients with hepatocelluar carcinoma and portal hypertension who underwent hepatectomy and splenectomy were reviewed. The relevant factors of postoperative complications were analyzed. Results The post- operative complication rate was 32.4% （22/68）. The main complications consisted of the splenic recess and pleural ef- fusion, infection of the effusion, bile leakage and so on. There was no relevance between the postoperative complication rate and the age, sex, serum AFP, HBV-DNA quantity and tumor location（ P 〉 0.05）. The postoperative complication rate was positively correlated to the tumor size, Child-pugh classification and severe degree of liver cirrhosis （P 〈 0.05）. Conclusion It can reduce complications after hepatectomy combined with splenectomy by perioperative man- agement to improve liver function and liver functional reserve.

关 键 词：肝癌 肝切除术 脾脏切除术 术后并发症 

分 类 号：R735.7[医药卫生—肿瘤]