泡型肝包虫病肝切除术后胆漏发生危险因素分析  

Risk factors leading to bile leakage after hepatectomy for hepatic alveolar echinococcosis

作　　者：张胜龙[1] 杨先伟[2] 王文涛[2] Zhang Shenglong;Yang Xianwei;Wang Wentao(Department of Hepatobiliary Surgery,Second People's Hospital of Chengdu,Chengdu 610017 China;Department of Liver Surgery,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]成都市第二人民医院肝胆外科,610017 [2]四川大学华西医院肝脏外科,成都610041

出　　处：《中华普通外科杂志》2020年第1期26-29,共4页Chinese Journal of General Surgery

基　　金：四川省科技计划项目重点研发项目(2019YFS0029)。

摘　　要：目的分析泡型肝包虫病术后胆漏发生的相关危险因素。方法回顾性分析137例泡型肝包虫的临床表现、实验室检查、影像学特征及手术情况,对比分析胆漏(n=22)与非胆漏组(n=115)的临床特征,Logistic回归模型探索胆漏发生的相关危险因素。结果胆漏组与非胆漏组在术前肝功能(AST、LAP、LDH)、失血量、输血量、肝门侵犯、术前行PICD、规则肝切除等比较,差异有统计学意义。Logistic回归分析显示,规则性肝切除是避免胆漏发生的保护性因素,肝门侵犯是胆漏发生的危险性因素。结论病灶侵犯肝门是术后胆漏发生的危险因素,规则性肝切除可降低术后胆漏发生率。Objective To analyze the risk factors of bile leakage after operation of hepatic alveolar echinococcosis.Methods The clinical manifestations,laboratory examination,imaging features and operative data of 137 patients with hepatic alveolar echinococcosis were retrospectively analyzed.The clinical characteristics of bile leakage group(n=22)and non-bile leakage group(n=115)were compared and analyzed,and the Logistic regression model was used to explore the related factors of bile leakage.Results Preoperative liver function(AST,ALP,LDH),blood loss,blood transfusion,hepatic hilum invasion,preoperative PTCD,and regular resection were significantly different between the two groups.Logistic regression analysis showed that regular hepatectomy was a protective factor to avoid bile leakage.Hepatic hilum invasion was a risk factor for bile leakage.Conclusion The invasion of the hepatic hilum is an important factor of postoperative bile leakage.Regular hepatectomy can reduce the incidence of postoperative bile leakage.

关 键 词：棘球蚴病 肝切除术 手术后并发症 危险因素 

分 类 号：R657[医药卫生—外科学]