体质量指数对肝硬化门静脉高压症断流术围手术期的影响  

Impact of body mass index on perioperative outcomes in patients who underwent surgery for cirrhotic portal hypertension

作　　者：徐军辉[1] 丁佑铭[1] 汪斌[1] 

机构地区：[1]武汉大学人民医院肝胆腔镜外科,430060

出　　处：《中华肝胆外科杂志》2014年第11期795-797,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的 研究体质量指数（BMI）对门静脉高压症合并脾功能亢进患者行脾切除术＋贲门周围血管离断术围手术期的影响.方法 前瞻性分析2002年4月至2012年6月我院310例因门静脉高压行脾切除术＋贲门周围血管离断术患者的临床资料.根据BMI将患者分为非肥胖组（BMI＜28 kg/m2）和肥胖组（BMI≥28 kg/m2）.肥胖组78例中男56例,女22例,平均年龄（48.7±8.3）岁;非肥胖组232例中男166例,女66例,平均年龄（46.3±6.9）岁.对比分析两组门静脉高压症患者围手术期的差异.结果 与非肥胖组比较,肥胖组年龄较大[（48.7±8.3）岁比（46.3±6.9）岁],术中失血量较多[（370±110） ml比（240 ±60）ml]、手术时间较长[（180±40） min比（150 ± 35） min]、围手术期输血量较大[（400±100） ml比（200±100） ml],差异具统计学意义（P＜0.05）;两组术后白蛋白水平[（28.1 ±2.6）g/L比（31.2 ±2.3）g/L]、术后引流液量[（280±70）ml比（230±60） ml]及住院时间[（10.5±3.0）d比（8.5±2.5）d],差异亦具统计学意义（P＜0.05）.而两组患者性别、术前肝功能水平以及术前和术后血小板数量、术后死亡方面无明显差异（P＞0.05）.结论 体质量指数是影响肝硬化门静脉高压症患者脾切除术＋贲门周围血管离断术围手术期的独立预后因素.Objective To analyze the impact of obesity on short-term prognosis in patients who underwent surgery for cirrhotic portal hypertension with hypersplenism.Methods The clinical data of 310 patients with cirrhotic portal hypertension who underwent splenectomy and portaazygous devascularization between Apr.2002 and Jue.2012 were prospectively analyzed.According to the body mass index （BMI）,these patients were divided into the non-obesity group （BMI ＜ 28 kg/m2） and the obesity group （BMI ≥28 kg/m2）.There were 78 patients in the obesity group （male：female 56：22; mean age 48.7 ± 8.3years）.There were 232 patients in the non-obesity group （male：female 166：66; mean age 46.3 ± 6.9years）.The postoperative outcomes in the two groups were analyzed.Results When compared with the nonobesity group,there were significant differences in age （48.7 ± 8.3 in obesity group vs 46.3 ± 6.9 years in non-obesity group）,perioperative blood transfusion （400 ± 100 vs 200 ± 100 ml）,intraoperative blood loss （370 ± 110 vs 240 ±60 ml）,operation time （180 ±40 vs 150 ±35 min）,serum albumin level after surgery （28.1 ±2.6 vs 31.2 ±2.3 g/L）,drainage volume （280 ±70 vs 230 ±60 ml） and hospital stays （10.5 ±3.0 vs 8.5 ± 2.5 days） in the obesity group （P ＜ 0.05）.However,there were no significant differences in gender,preoperative level of liver function,platelet counts （preoperative and postoperative） and postoperative deaths （P ＞ 0.05）.Conclusion BMI was a significant independent prognosis risk factor for patients with cirrhotic portal hypertension undergone splenectomy and portaazygous devascularization.

关 键 词：门静脉高压症 体质量指数 围手术期 断流术 

分 类 号：R657.34[医药卫生—外科学]