肝胆管结石病肝切除术后并发症发生的危险因素分析  

Analysis of risk factors for complications after hepatectomy for hepatolithiasis

作　　者：赖依林 王如意 刘智鹏 杨雪儿 罗宇乐 白洁 江艳 金烁 戴海粟 陈志宇 LAI Yi-lin;WANG Ru-yi;LIU Zhi-peng;无(Department of Hepatobiliary Surgery,Army Hepatobiliary Surgery Research Institute,The First Affliated Hospital of Army Medical University,Chongqing 400038,China;Hepato-Biliary-Pancreatic Center,Tsinghua Changgung Hospital Affiliated to Qsinghua University,Beijing 102218,China)

机构地区：[1]陆军军医大学第一附属医院(西南医院)肝胆外科全军肝胆外科研究所,重庆400038 [2]清华大学附属北京清华长庚医院肝胆胰中心,北京102218

出　　处：《肝胆外科杂志》2024年第4期247-251,共5页Journal of Hepatobiliary Surgery

基　　金：西南医院孵化项目(2023IITZD06)

摘　　要：目的 探讨影响肝胆管结石病人肝切除术后并发症发生的独立危险因素。方法 回顾性地收集并分析2006年至2022年间陆军军医大学第一附属医院和北京清华长庚医院收治的行肝切除术的肝胆管结石病患者的临床资料。采用单因素及多因素Logistic回归分析影响肝胆管结石病人肝切除术后并发症发生的独立危险因素。结果 本研究共纳入430例行肝胆管结石病肝切除术患者,其中,发生并发症的患者254例(59.0%),其年龄、ASA评分、手术时间、术中失血量、术中输血率、开放手术率、小范围肝切除率均显著高于未发生并发症的患者(P<0.05)。多因素Logistic回归分析结果显示:年龄>70(岁)、手术方式(开放)、术中失血>1000(ml)是影响肝胆管结石病肝切除术后并发症发生的独立危险因素(P<0.05)。结论 年龄、手术方式、术中失血是肝胆管结石病肝切除术后并发症发生的独立危险因素。为控制并发症发生的风险,在临床实践中可重点关注伴有危险因素的人群。Objective To explore the independent risk factors of complications after hepatectomy in patients with hepatolithiasis.Methods Clinical data of the patients with hepatolithiasis who underwent hepatectomy in the First Affiliated Hospital of Army Medical University and Tsinghua Changgung Hospital Affiliated to Tsinghua University from 2006 to 2022 were retrospectively collected and analyzed.Univariate and multivariate Logistic regression analysis were used to analyze the independent risk factors affecting the occurrence of complications after hepatectomy in patients with hepatolithiasis.Results A total of 430 patients underwent hepatectomy for hepatolithiasis were included in this study.Among whom 254 patients(59.0%)had complications.Their age,ASA score,operation time,intraoperative blood loss,intraoperative blood transfusion rate,routine laparotomy rate and small hepatic resection rate were significantly higher than those without complications(P<0.05).Multivariate Logistic regression analysis showed that age>70(years old),surgical approach(Laparotomy),and intraoperative blood loss>1000(ml)were independent risk factors for complications after hepatectomy for hepatolithiasis(P<0.05).Conclusions Age,surgical approach and intraoperative blood loss are independent risk factors for complications after hepatectomy for hepatolithiasis.To control the risk of complications,people with risk factors can be focused on in clinical practice.

关 键 词：肝胆管结石病 肝切除术 并发症 危险因素 

分 类 号：R657.4[医药卫生—外科学]