肝癌患者肝部分切除术后感染相关因素分析  

Related risk factors for postoperative infections in hepatocellular carcinoma patients undergoing partial hepatectomy

作　　者：刘清[1] 惠永丰 卜稳平 刘迪[1] 李楠[1] 

机构地区：[1]宁夏医科大学总医院肝胆外科,宁夏银川750004

出　　处：《中华医院感染学杂志》2017年第16期3719-3721,共3页Chinese Journal of Nosocomiology

基　　金：宁夏回族自治区自然科学基金项目(NZ14127)

摘　　要：目的分析探讨肝癌患者肝部分切除术后感染相关并发症的发生情况及其危险因素。方法选择2014年1月-2016年6月医院收治的262例行肝部分切除术的肝癌患者的临床资料进行回顾性研究,根据患者术后感染发生情况分为感染患者73例与未感染患者189例,对比感染与未感染患者的临床基础资料、术前各项指标的检查结果和相关手术指标等情况,分析引发患者感染的相关因素。结果有73例患者发生术后感染,感染率为27.86%;单因素分析结果显示,患者年龄、白蛋白水平、术前是否合并糖尿病、手术时间、术中出血量、术中输血量、术后是否发生胆瘘、术后引流管留置时间均是患者发生感染的相关因素(P<0.05)。结论对于行肝部分切除术的肝癌患者,在临床治疗过程中有效控制患者的白蛋白水平、改善患者的糖尿病情况、缩短手术时间、减少术中出血、降低术后胆瘘发生率、缩短留置引流管的时间可以有效地改善患者的感染发生情况,预防危险因素的发生以降低感染的发生率。OBJECTIVE To explore the related risk factors for postoperative infections in hepatocellutar carcinoma （HCC） patients undergoing partial hepatectomy. METHODS The clinical data of 262 HCC patients who underwent the partial hepatectomy in the hospital from Jan 2014 to Jun 2016 were retrospectively analyzed, the enrolled pa- tients were divided into the infection group with 73 cases and the non-infection group with 189 cases according to the status of the postoperative infections. The clinical baseline data, preoperative examination indexes and related surgical indexes were observed and compared between the patients with infections and the patients without infec- tions, and the related risk factors for the infections were analyzed. RESULTS Totally 73 patients had the postoper- ative infections, with the infection rate 27.86%. The result of univariate analysis indicated that the related risk factors for the infections included the age, albumin level, preoperative complication with diabetes mellitus, opera- tion duration, intraoperative bleeding volume, intraoperative blood transfusion volume, postoperative biliary fistu- la and postoperative drainage tube indwelling time （P〈0.05）. CONCLUSION It is an effective way to control the albumin level during the clinical treatment, improve the status of diabetes mellitus, shorten the operation dura- tion, reduce the intraoperative bleeding volume, decrease the incidence of postoperative biliary fistula, shorten the drainage tube indwelling time and prevent the risk factors so as to reduce the incidence of the infections.

关 键 词：肝癌 肝部分切除术 感染 并发症 

分 类 号：R735.7[医药卫生—肿瘤]