胃癌并发肝硬化患者手术后发生腹水的相关因素研究  

Related factors of postoperative ascites in patients with gastric cancer and liver cirrhosis

作　　者：边志民[1] 赵新颜[2] 

机构地区：[1]中国医学科学院肿瘤医院综合科,北京100029 [2]首都医科大学附属北京友谊医院肝病中心,北京100050

出　　处：《中华普外科手术学杂志（电子版）》2015年第3期38-40,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金(81000178)~~

摘　　要：目的探讨外科治疗胃癌并发肝硬化患者发生腹水的相关因素。方法回顾性分析胃癌合并肝硬化患者且行外科手术治疗的患者82例,将患者的性别,年龄,术前腹水情况,Child-pugh分级情况,术中出血量,手术时间,胃癌的部位,是否根治术,肿瘤大小等因素采用SPSS 17.0统计软件进行处理,发生腹水的单因素分析计数资料采用χ2检验,将单因素分析中差异有统计学意义的变量纳入Logistic回归分析,计算其比值比(OR)及95%的可信区间,所得结果 P<0.05为差异具有统计学意义。结果年龄,术前腹水情况,Child-pugh分级情况,术中出血量,肿瘤大小为外科治疗胃癌并发肝硬化患者发生腹水的相关影响因素,将上述相关影响因素纳入到Logistic回归多因素分析发现,术前腹水情况,Child-pugh分级情况,术中出血量,肿瘤大小为外科治疗胃癌并发肝硬化患者发生腹水的独立影响因素。结论对于胃癌并发肝硬化患者的治疗一定要尽量精确的评价患者的肿瘤大小以及术前的腹水情况,积极调整患者的肝功能提升Child-pugh分级到A级,控制术中的出血量,尽量科学有效的控制术后腹水的发生。Objective To explore the related factors of postoperative ascites in patients with gastric carcinoma complicated with cirrhosis. Methods Eighty-two patients with gastric cancer and liver cirrhosis after operation were analyzed retrospectively , in terms of sex, age, preoperative ascites, Child-pugh classification, the amount of bleeding during the operation, operative time, tumor location, radical resection, tumor size etc. SPSS17.0 statistical software was used for data processing, the data on occurrence of ascites was determined by univariate analysis using the Chi-square test. The difference was statistically significant. Variables were analyzed by Logistic regression to calculate the odds ratio （OR） and 95% confidence interval. A P value 〈 O. 05 was considered as statistically significant. Results Age, preoperative aseites, Child-pugh classification, amount of bleeding during the operation, tumor size for surgical treatment of patients with gastric cancer complicated with liver cirrhosis were analyzed, and multivariate Logistic regression analysis showed that preoperative ascites, Child-pugh classification, the amount of bleeding in operation, and tumor size were independent influencing factors of patients with gastric cancer concurrent liver cirrhosis ascites after surgical treatment. Conclusion Before surgical treatment, patients with gastric cancer complicated with liver cirrhosis should have an accurate evaluation of tumor size, preoperative ascites, active improvement of liver function to Child-pugh grade A for the control of the amount of bleeding during operation and postoperative occurrence of ascites.

关 键 词：胃肿瘤 肝硬化 腹水 因素分析 统计学 

分 类 号：R735.2[医药卫生—肿瘤] R575.2[医药卫生—临床医学]