大范围肝切除术后肝衰竭危险因素分析  

Risk factors analysis of hepatic failure after major hepatectomy

作　　者：曾柏强 吴祥[1] 冉义洪 罗旋[1] 张红卫[1] Zeng Baiqiang;Wu Xiang;Ran Yihong;Luo Xuan;Zhang Hongwei(Department of Hepatobiliary Surgery,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院肝胆外科,广州510120

出　　处：《中华肝脏外科手术学电子杂志》2018年第2期143-146,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：北京市希思科临床肿瘤学研究基金(Y-2009-017)

摘　　要：目的探讨大范围肝切除术后肝衰竭危险因素。方法回顾性研究2008年1月至2017年2月中山大学孙逸仙纪念医院收治的293例大范围肝切除术患者临床资料。患者均签署知情同意书,符合医学伦理学规定。根据有否发生术后肝衰竭,将患者分成肝衰竭组和无肝衰竭组。其中肝衰竭组23例,男22例,女1例;平均年龄(53±12)岁。无肝衰竭组270例,男224例,女46例;年龄(49±12)岁。采用单因素分析和Logistic回归分析分析术后肝衰竭的危险因素。结果大范围肝切除术患者术后肝衰竭发生率7.8%(23/293)。多因素Logistic回归分析显示术前Plt、肝功能ChildPugh分级、肿瘤直径、血管癌栓为术后发生肝衰竭的独立影响因素(OR=0.983,0.020,0.726,0.225;P<0.05)。结论术前肝功能Child-Pugh分级、Plt、肿瘤直径、血管癌栓为大范围肝切除术后肝衰竭的独立影响因素。Objective To explore the risk factors of hepatic failure after major hepatectomy.Methods Clinical data of 293 patients receiving major hepatectomy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2008 and February 2017 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.According to whether there was postoperative hepatic failure,the patients were divided into the hepatic failure group and non-hepatic failure group.There were 23 cases in the hepatic failure group,including 22 males and 1 female with the mean age of(53±12)years.There were 270 cases in non-hepatic failure group,including 224 males and 46 females with the age of(49±12)years.Single factor analysis and Logistic regression analysis were used to analyze the risk factors of postoperative hepatic failure.Results The incidence of hepatic failure after major hepatectomy was 7.8%(23/293).Multi-factor Logistic regression analysis showed that preoperative Plt,Child-Pugh classification of liver function,tumor diameter and vascular tumor thrombus were the independent influence factors of postoperative hepatic failure(OR=0.983,0.020,0.726,0.225;P<0.05).Conclusion Preoperative Plt,Child-Pugh classification of liver function,tumor diameter and vascular tumor thrombus are the independent influence factors of hepatic failure after major hepatectomy.

关 键 词：肝肿瘤 肝切除术 肝功能衰竭 危险因素 

分 类 号：R575.3[医药卫生—消化系统] R735.7[医药卫生—内科学]