肝叶切除术后发生肺栓塞的原因与预防  

Causes and prevention of pulmonary embolism after hepatectomy

作　　者：肖体君[1] 刘娟 欧阳林[1] 范轲炜 XIAO Tijun;LIU Juan;OUYANG Lin;FAN Kewei(Department of General Surgery,The Second Affiliated Hospital of Shaoyang University,Shaoyang 422000,China)

机构地区：[1]邵阳学院附属第二医院普外科,湖南邵阳422000

出　　处：《邵阳学院学报（自然科学版）》2020年第5期26-30,共5页Journal of Shaoyang University：Natural Science Edition

基　　金：湖南省教育厅科学研究项目(17C1430)。

摘　　要：目的分析肝叶切除术后并发肺栓塞的临床特点,总结临床肝叶切除术后肺栓塞诊治经验及防治策略,提高肝胆外科临床医师对肝叶切除术后并发急性肺栓塞的认识及救治能力。方法回顾分析邵阳学院附属第二医院2010年1月至2020年1月期间的各型肝脏病变行肝叶切除术术后肺栓塞患者的病例资料,对肝叶切除术后发生肺栓塞与未发生肺栓塞的病例资料进行对比分析。统计学方法使用SPSS 22.0数据分析软件进行统计学处理。结果发生肺栓塞患者中心静脉置管、肿瘤、糖尿病、肺气肿、活动时间、体质量指数、手术时长与整体肝切除术后患者相比,差异均有统计学意义(P<0.05),上述因素均为肝叶切除患者并发肺栓塞的危险因素。患者在年龄、性别、抽烟史、饮酒史、心血管疾病、D-二聚体、输血史等方面,差异无统计学意义(P>0.05)。结论中心静脉置管、肿瘤、糖尿病、肺气肿、活动时间、体质量指数、手术时长均为肝叶切除术后患者合并肺栓塞的相关危险因素。Objective To analyze the clinical features of pulmonary embolism after hepatectomy,summarize the experience of diagnosis and prevention strategies of pulmonary embolism after hepatectomy,and improve the understanding and rescue ability of hepatobiliary surgeons on acute pulmonary embolism after hepatectomy.Methods The data of patients with pulmonary embolism after hepatic lobectomy of various types of liver diseases in the Second Affiliated Hospital of Shaoyang University in recent years were analyzed,and the clinical date of patients with and without pulmonary embolism after hepatic lobectomy were compared.According to the statistical.Results Clinical observation results:the central venous catheterization,tumor,diabetes mellitus,emphysema,activity time,body mass index,and duration of operation in patients with pulmonary embolism were statistically significant compared with patients of total hepatectomy(P<0.05).The above factors were all risk factors for pulmonary embolism in patients with hepatectomy.There was no significant difference in age,gender,smoking history,drinking history,D-dimer,cardiovascular disease,blood transfusion history,etc.Conclusion Central venous catheterization,tumor,diabetes mellitus,emphysema,activity time,body mass index,and operation time are all associated risk factors of pulmonary embolism in patients with hepatic lobectomy.

关 键 词：肝叶切除术后 肺栓塞 危险因素 

分 类 号：R61[医药卫生—外科学]