原发性肝癌肝切除术后并发症严重程度影响因素分析(附84例报告)

Risk factors of complications severity after hepatectomy for primary liver cancer: A report of 84 patients

目的探讨影响原发性肝癌肝切除术后并发症严重程度的危险因素。方法回顾性分析2011年1月至2012年12月青岛大学医学院附属医院肝胆外科收治的原发性肝癌肝切除术后出现并发症的84例病人临床资料。根据Strasberg提出的外科并发症严重程度分级方法,将发生并发症病人分为轻度和重度并发症组,分析导致重度并发症发生的危险因素。结果 84例病人（94例次并发症）中轻度并发症者59例,重度并发症者25例。无因并发症死亡病例。单因素分析显示,肝功能Child-Pugh B级、术中出血≥500 m L、术中输血是术后发生重度并发症的危险因素（P〈0.05）;多因素分析结果显示,肝功能Child-Pugh B级是肝切除术后重度并发症发生的独立危险因素（OR=5.139,95%CI 1.103~23.944,P=0.033）。结论肝功能Child-Pugh B级原发性肝癌病人术后易发生重度并发症。

Objective To explore the risk factors of complications＇ severity after hepatectomy for primary liver cancer. Methods The clinical data of 84 patients with comlications who underwent hepatectomy for primary liver cancer from January 2011 to December 2012 in Department of Hepatobiliary Surgery, the Affiliated Hospital of Qingdao University were analyzed retrospectively. The patients who had postoperative complications were divided into two groups according to the severity of complications： the mild group and heavy group, respectively. The predictors of severe complications were studied by univariate and multivariate analysis. Results 84 patients （94 times of complications） included 59 patients in mild group and 25 patients in heavy group. There was no death related to complications by the univariate analysis, Child-Pugh B grade, bleeding≥500 mL and intraoperative blood transfusion were related to severe complications （P〈0.05）. By the multivariate analysis of the heavy group, Child-Pugh B grade was an independent risk factor（OR=5.139,95%CI 1.103-23.944,P=0.033）. Conclusion The patients of primary liver cancer with Child-Pugh B grade were more likely to suffered from severe postoperative complications.