多元回归分析肝切除术后胸腔积液的危险因素  

Multivariate analysis of risk factors for pleural effusion after hepatectomy

作　　者：程翔[1] 郭兵[1] 高阳[1] 郑启昌[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院肝胆外科,武汉430022

出　　处：《中华实验外科杂志》2014年第5期1111-1113,共3页Chinese Journal of Experimental Surgery

摘　　要：目的评估肝切除术后发生胸腔积液的危险因素。方法前瞻性收集和回顾性分析我院2011年1月至2012年12月行肝切除手术470例患者的临床资料，采用多元回归分析法对围手术期各项危险因素进行分析。结果单因素分析可见18个围手术期因素与术后胸腔积液相关，分别为糖尿病、术前腹水、肝功能Child分级、肿瘤直径、肿瘤边界、肿瘤侵犯血管、肿瘤肝外转移、术中微波热凝、术中胆肠吻合、手术时间、肝门阻断时间、术中失血量、术中输血量、腹腔引流管数量、手术13总输液量、术后输血量、胃管放置时间、术后胆漏。多元回归分析明确了两个独立危险测素为手术时间[比值比（OR）=10．2（6．30～16．50），P〈0．01]和手术日总输液量[OR=1．0（1．00～1．00），P〈0．01]。结论手术时间和手术日输液总量是肝切除术后胸腔积液的独立危险因素。Objective To evaluate the risk factors of pleural effusion after liver resection. Methods Between January 2011 and December 2012, 470 patients underwent elective hepatectomy. We prospectively collected and retrospectively analyzed demographic data, pathological variables, associated pathological conditions, and preoperative, iutraoperative, and postoperative variables. Multivariate analysis identified the independent risk factors of postoperative pleural effusion. Results Univariate Analysis identified 18 risk factors for pleural effusion after liver resection： Diabetes, Preoperative aseites, Child-Pugh grade, Size of major lesion, Tumor margin, Portal vein invasion or portal branch thrombosis, Extrahepatic metastases, Microwave solidification, Bilioenterie anastomosis, Operative time, Portal triad clamping, Intraoperafive blood loss, Intraoperative blood transfusion, Number of abdominal drains, Infusion volume of the surgery day, Postoperative blood transfusion, Length of nasogastric tube and Bile leakage. Multivariate analysis identified 2 independent risk factors for postoperative pleural effusion ： Operative time [ odds ratio （ OR = 10. 2 （6. 30-16. 50） ,P 〈0. 01 ], infusion volume of the surgery day [ OR = 1.0 （1.00-1.00） ,P 〈 0. 01]- Conclusion Operative time and infusion volume of the surgery day were identified as independent risk factors for pleural effusion after liver resection.

关 键 词：肝切除术 胸腔积液 

分 类 号：R657.3[医药卫生—外科学]