肝切除术后全身性炎症反应发生率及其影响因素分析

Analysis of incidence and influencing factors of systemic inflammatory response syndrome after hepatectomy

目的统计分析肝切除术后患者SIRS的水平及动态变化,为临床进一步降低肝切除患者的感染率提供帮助。方法调查我院单个治疗组近4年来收治的肝切除患者发生的SIRS情况,并进行回顾性分析。结果 232例肝切除患者中发生SIRS的有226例,总发生率为96.98%;随着术后天数的延长,SIRS发生的严重程度呈逐步下降趋势;原发性肝癌组术后SIRS达峰值与肿瘤最大径、肝硬化相关;SIRS评分与选择双联或者三联抗菌药物之间并不存在可比性。结论我院单个治疗组肝切除术后患者SIRS的发生率高,应用SIRS评分重视早期发现SIRS,对提高肝切除的治愈率,降低感染率,具有一定的临床意义。

Objective To analyze the lever and dynamics of systemic inflammatory response syndrome in the patients after hepateetomy, so as to provide some references for the treatment of preventing SIRS and decrease of infection rate. Methods The occurrence of SIRS on patients of hepatectomy in single treatment group nearly 4 years were surveyed byretrospective analysis. Results The rate of SIRS was 96.98% in the 232 cases of hepatectomy. SIRS severity occurred gradually declined with the extension of treatment after surgery. The SIRS Peak after surgery was correlated with maximum tumor diameter and cirrhosis of liver on primary liver cancer group. There was no comparability between the SIRS Score and antibiotics combined with double or triple. Conclusions The application of SIRS Score and early detection of SIRS was a certain clinical significance to improve the cure rate of liver resection and reduce infection rates.