原发性肝癌肝切除术后肝功能衰竭的相关因素分析及防治

Risk factor analysis and treatment for hepatic failure after hepatectomy for primary liver cancer

目的:探讨原发性肝癌术后肝功能衰竭的原因和防治。方法:回顾性分析379例原发性肝癌切除术患者的临床资料。结果:在379例肝癌患者中18例肝切除后发生了肝功能衰竭。术后发生肝功能衰竭的患者术中出血量明显多于没有发生肝功能衰竭的患者。结论:术中出血量多合并严重肝硬化是原发性肝癌肝切除术后发生肝功能衰竭的重要原因,尤其是合并门脉高压症者不可盲目追求进行根治性肝癌切除术。

Objective： To investigate the cause of hepatic failure , which developed after hepatectomy for primary liver cancer ,and the strategy to avoid it . Methods： Analysis of clinical data of primary liver cancer patients underwent hepatectomy in the past five years retrospectively. Results ：Of the 379 patients , 18 had hepatic failure after hepatectomy（3.7%） . The amount of intraoperative bleeding was significantly higher in the patients with post-operative hepatic failure in those without （P 〈 0. 01） . Conclusion ： The amount of intraoperative bleeding and severe cirrhosis are important risk factors for hepatic failure of patients with primary liver cancer after operation . We claim that extending eradical resection should not be done before profound consuderation to the patients with primary liver cancer.