肝癌TACE术并发肝脓肿的临床特征及危险因素分析

Clinical features and risk factors analysis of liver abscess after liver cancer TACE

目的探讨肝癌TACE术并发肝脓肿的临床表现特点及危险因素。方法回顾2003年5月—2008年3月1 156例肝癌患者行TACE术3 378次术后并发肝脓肿的发病率、临床特点、治疗转归等,分析TACE术后发生肝脓肿的危险因素。结果共有21例患者TACE术后发生肝脓肿,肝脓肿并发症的发生率为0.62%(3 378次操作)。肝脓肿的临床表现为肝区疼痛、肝大、发热、白细胞增多等,发病时间为术后7～20 d,平均(12±6)d.肝癌TACE术后并发肝脓肿患者在性别比例,胆道损伤,胆道阻塞,营养状况差等方面与对照组比较差异有统计学意义(P<0.05或P<0.01)。结论肝癌TACE术后肝脓肿并发症具有一定的临床特点,女性患者、胆道损伤、胆道梗阻、营养状况差等是TACE术后发生肝脓肿的危险因素。

Objective To study the clinical feature and risk factors analysis of liver abscess after liver cancer TACE. Methods During May 2003 to March 2008,1 156 patients with liver cancer underwent 3 378 times TACE,and complicated with liver abscess.The incidence rate,clinical features and treatment outcome were reviewed and the risk factors of liver abscess after TACE were analyzed. Results Liver abscess occurred in 21 cases,the incidence rate of liver abscess was 0.62%（3 378 times operations）.The clinical features of liver abscess were hepatalgia,hepatomegaly,fever,leukocytosis and so on.It occurred 7-20 days after operation,and the average time was（12±6）d. The assay has statistical significance when it compared with control group,they compared in sex ratio,biliary tract damage,biliary tract block,bad nutriture（P0.05 or P0.01）. Conclusion Liver abscess after TACE had some clinical features,the risk factors of liver abscess after TACE operation were female patients,biliary tract damage,biliary tract block and bad nutriture.