肝切除治疗老年肝内胆管结石患者术后严重并发症的危险因素分析  

Multiple Factors Analysis of Severe Postoperative Complications after Hepatectomy in Elderly Patients with Hepatolithiasis

作　　者：胡大仁[1] 刘定志[1] HU Daren;LIU Dingzhi(Department of Hepatobiliary Surgery,Chongqing Three Gorges Central Hospital,Chongqing City 404100)

机构地区：[1]重庆三峡中心医院肝胆外科

出　　处：《医学理论与实践》2019年第12期1801-1803,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨肝切除治疗老年肝内胆管结石患者术后严重并发症的危险因素。方法:选取2010年1月—2015年6月98例于我院行肝切除术的老年肝内胆管结石患者,分析其术后严重并发症及相关危险因素。结果:本组13例患者术后出现严重并发症,发生率为13.27%。单因素分析结果显示术后严重并发症的发生与既往胆道手术史、ASA分级、胆汁性肝硬化、术前Child-Pugh分级、术中出血量及手术时间相关(均P<0.05)。多因素分析结果显示ASA分级Ⅲ级、胆汁性肝硬化、手术时间≥4h是术后严重并发症发生的独立危险因素(均P<0.05)。结论:老年肝内胆管结石患者肝切除术后严重并发症的发生率较高,尤其是ASA分级Ⅲ级、胆汁性肝硬化、手术时间≥4h的患者。Objective:To explore the risk factors of severe postoperative complications after hepatectomy in elderly patients with hepatolithiasis.Methods:The clinical data of 98 elderly patients with hepatolithiasis underwent hepatectomy from January 2010 to June 2015 were reviewed.The possible risk factors pertaining to the development of severe postoperative complications were identified using univariate and multivariate analysis.Results:13 cases occurred severe postoperative complications and the incidence was 13.27%.Univariate analysis identified the following risk factors as history of biliary tract surgery,ASA classification,biliary cirrhosis,preoperative Child-pugh grade,blood loss and operation time (all P <0.05).Logistic regression analysis revealed that ASA grade Ⅲ,biliary cirrhosis and operation time ≥4h were independent risk factors for severe postoperative complications (All P <0.05).Conclusion:The elderly patients with hepatolithiasis underwent hepatectomy have a high incidence,especially for those ASA grade Ⅲ,biliary cirrhosis and operation time ≥4h patients.

关 键 词：老年 肝切除 肝内胆管结石 危险因素 

分 类 号：R657.42[医药卫生—外科学]