原发性肝癌肝切除术后发生肝功能衰竭的围术期影响因素分析  

Clinical analysis of factors of perioperative liver failure after hepatectomy

作　　者：刘朝辉[1] 杜振双[1] 林建泉[1] 陈一杰[1] 

机构地区：[1]解放军第180医院普外科,泉州362000

出　　处：《肝胆外科杂志》2016年第5期375-377,共3页Journal of Hepatobiliary Surgery

摘　　要：目的研究原发性肝癌肝切除后患者发生肝功能衰竭的围术期影响因素。方法回顾性分析2011年6月一2015年6月我院收治的原发性肝癌肝切除术后患者526例的临床资料,依据术后是否发生肝功能衰竭将患者分为肝功能衰竭组和无肝功能衰竭组,采用单因素分析和Logistic回归分析肝功能衰竭的围术期危险因素。结果术后发生肝功能衰竭125例,其发生率为23.76%,其中16例患者死于肝功能衰竭,病死率为3.04%。两组患者的年龄、血小板计数、谷草转氨酶、肝功能Child-Pugh分级、合并血管癌检情况、合并基础疾病情况、术前是否行TACE、术中出血量比较,差异均存在统计学意义(P<0.05)。Logistic回归分析结果显示,肝功能Child-Pugh分级、合并血管癌栓、术前是否TACE、术中出血量对是否发生肝功能衰竭均有影响,差异均有统计学意义(P<0.05)。结论肝功能Child-Pugh分级、合并血管癌栓、术前是否TACE及术中出血量是原发性肝癌肝切除术后患者发生肝功能衰竭的围术期独立影响因素。Objective To investigate the perioperative risk factors for liver failure after hepatectomy of primary hepatic carci- noma（PHC）. Methods Clinical and pathological data of 526 PHC patients having undergone hepatectomy of PHC admit-ted into our hospital between June 2011 and June 2015 were retrospectively analyzed. The patients were divided into liver failure group and non- failure group based on whether postoperative liver failure, Univariate and Logistic Regression analyses were used for data analysis. Re- stilts Among 526 patients with hepatectomy, 125 patients （23.76%） occurred liver failure, and liver failure caused mortality was 3.04 % （16/526）. Significant differences were observed between the two groups in age, platelet count, Child-Pugh classification, com- bined vascular embolism, combined underlying diseases, by TACE before the surgery and intraoperative bleeding amount（ P 〈 0. 05 ） Logistic regression analysis results showed that Child-Pugh classification, combined vascular embolism, by TACE before the surgery and intraoperative bleeding had significant impact the live failure （ P 〈 0. 05 ）. Conclusion Child-Pugh classification, combined vascular embolism, by TACE before the surgery and intraoperative bleeding were independent factors for liver failure after hepateetomy of PHC.

关 键 词：肝肿瘤 肝切除术 肝衰竭 独立因素 

分 类 号：R735.7[医药卫生—肿瘤]