Child-Pugh分级与肝硬化患者胆道术后出血相关性分析

Research for correlative between Child-Pugh classification and postoperative bleeding in biliary surgery in patients combined with cirrhosis

目的探讨Child-Pugh分级与肝硬化胆道术后出血的相关性,总结围术期处理经验。方法分析1990年1月—2010年1月武汉市协和医院收治的627例肝硬化病人行胆道手术的出血情况。结果 本组627例病人,术后出血28例,因术后出血死亡3例。3个肝功能级别术后出血率比较差别具有统计学意义(P<0.05)。不同肝功能级别术后出血率两两比较,Child A级与B级差异无统计学意义(P>0.05),Child A、B级与Child C级差异有统计学意义(P<0.01)。结论不同Child-Pugh分级的肝硬化患者胆道术后出血率存在差异,当肝功能评分升高时术后出血危险性显著增加。重视肝功能分级及围术期处理是减少术后出血发生的关键。

Objective To analyze the correlation between Child-Pugh classification and postoperative bleeding in biliary surgery in the patients combined with cirrhosis,and to summarize the experience in perioperative treatment.Methods Correlative analysis was made in 627 patients with cirrhosis who had undergone biliary surgery from January 1990 to January 2010 in Wuhan Union Hospital.Results In this group,postoperative bleeding was found in 28 ones,3 of whom died.There were differences in postoperative bleeding among the three classes of liver function(P<0.05).There was no significant difference between Child A and Child B(P>0.05),while each of the above two showed an obvious difference from Child C(P<0.01).Conclusion Among the patients with liver cirrhosis of different Child-Pugh classifications,statistic discrepancy exists in the risk of Haemorrhage after biliary surgery,and with the increase in Child-Pugh scoring,the risk of Haemorrhage after biliary surgery increases markedly.Attaching importance to classification of liver function and perioperative handling is the key to lower the possibility of postoperative bleeding.