肝脏肿瘤患者射频消融术后肝内感染的危险因素分析  

Risk factors for postoperative intrahepatic infections in patients undergoing radiofrequency ablation

作　　者：孙阿妮[1] 刘燕[1] 于凌波[1] 

机构地区：[1]潍坊市人民医院科教信息部培训中心,山东潍坊261041

出　　处：《中华医院感染学杂志》2015年第21期4947-4948,4951,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技攻关基金资助项目(2011GGB14111)

摘　　要：目的研究肝脏肿瘤患者行射频消融(RFA)后引起肝内感染的危险因素,为临床治疗提供依据。方法选择2011年1月-2013年3月住院行RFA治疗的142例肝癌患者,记录其性别、年龄、既往手术史、射频消融术式、抗菌药物预防感染、肿瘤类型以及Child-Pugh分级等,统计分析上述变量对射频消融术后发生肝内感染的相关性。结果 142例患者行186例次射频消融术,其中发生肝内感染10例次,性别、年龄、肝功能Child-Pugh分级、抗菌药物预防感染使用对肝脏射频消融术后肝内感染的发生率无显著相关,而多发性肿瘤、转移性肝癌、有腹部手术史,尤其是胆肠吻合术和开腹射频消融术的肝内感染率显著高于多发性肿瘤(12.96%与2.27%;χ2=6.636;P=0.010)、原发性肝癌(13.16%与3.38%;χ2=3.925;P=0.048)、无腹部手术史(9.78%与1.06%;χ2=3.925;P=0.048)和经皮射频消融(10.00%与1.89%;χ2=4.412;P=0.036);转移性肝癌、既往胆肠吻合术、多发肝脏肿瘤和开腹RFA这4个因素均为引起RFA后肝内感染的独立危险因素。结论继发性肝癌、多发性肝脏肿瘤、既往有腹部手术史和开腹术式是肝脏肿瘤射频消融后发生肝内感染的危险因素。OBJECTIVE To explore the risk factors for postoperative intrahepatic infections in patients undergoing radiofrequency ablation（RFA）so as to provide guidance for clinical treatment.METHODS A total of 142 liver cancer patients（186case-times）who were hospitalized and underwent RFA from Jan 2011 to Mar 2013 were enrolled in the study,then the gender,age,history of surgery,the way of RFA,antibiotics prophylaxis,type of tumor,and Child-Pugh classification were recorded,and the correlation between the above variables and the postoperative intrahepatic infections were statistically analyzed.RESULTS Of 186 patients undergoing RFA,10 casetimes had the intrahepatic infections.The incidence of the postoperative intrahepatic infections in the patients undergoing RFA was not significantly associated with the gender,age,Child-Pugh liver function classification,or antibiotics prophylaxis.However,the incidence of the intrahepatic infections was significantly higher in the patients with multiple tumors,metastatic liver cancer,history of abdominal surgery especially choledochojejunostomy,or laparotomy RFA than in the patients with multiple tumors（12.96% and 2.27%;χ^2=6.636;P=0.010）,the patients with primary liver cancer（13.16% and 3.38%;χ^2=3.925;P=0.048）,the patients without history of abdominal surgery（9.78% and 1.06%;χ^2=3.925;P=0.048）,or the patients undergoing percutaneous RFA（10.00% and 1.89%;χ^2=4.412;P=0.036）.The independent risk factors for the postoperative intrahepatic infections included the metastatic liver cancer,history of choledochojejunostomy,multiple liver tumors,and laparotomy RFA.CONCLUSION The risk factors for the postoperative intrahepatic infections in the patients undergoing RFA include the secondary liver cancer,multiple liver tumors,history of abdominal surgery and laparotomy.

关 键 词：射频消融 肝内感染 危险因素 肝脏肿瘤 

分 类 号：R619.3[医药卫生—外科学]