肝癌患者肝切除术后感染性并发症的相关危险因素分析

Analysis of the risk factors for infectious complications in patients with hepatocellular carcinoma after hepatectomy

目的探讨肝癌患者肝切除术后发生感染性并发症的相关危险因素。方法回顾性分析2008年1月至2015年9月在新乡医学院第一附属医院行肝切除术的241例原发性肝癌患者的临床资料,根据术后是否出现感染性并发症,将患者分为感染组(n=32)和非感染组(n=209),采用单因素分析和多因素logistic回归方法分析肝癌患者肝切除术后发生感染性并发症的相关危险因素。结果 241例肝癌患者肝切除术后发生感染性并发症32例,未发生感染性并发症209例,感染性并发症发生率为13.27%。多因素logistic回归分析显示,术前合并糖尿病、血清白蛋白水平低、术中失血量大、术中输血量大、腹腔引流管放置时间长及术后合并胆瘘是肝癌肝切除术后感染性并发症发生的独立危险因素(P<0.05)。结论术前合并糖尿病、血清白蛋白水平低、术中失血量大、术中输血量大、腹腔引流管时间长及术后合并胆瘘是肝癌患者肝切除术后发生感染性并发症的独立危险因素。

Objective To explore the risk factors for infectious complications in patients with hepatocellular carcinoma after hepatectomy. Methods The clinical data of 241 patients with primary liver cancer who underwent hepatectomy in the First Affiliated Hospital of Xinxiang Medical University from January 2008 to September 2015 were analyzed retrospectively. All the patients were divided into infection group （n = 32） and non infection group（ n = 209） according to postoperative infectious complications. The risk factors for postoperative infectious complications were analyzed by univariate analysis and multivariate logistic regression analysis in patients with hepatocellular carcinoma. Results Among the 241 patients with hepatocellular carcinoma, the postoperative infectious complications occurred in 32 patients, and there was no infectious complication in 209 patients, the rate of infectious complications was 13.27%. Multivariate logistic regression analysis showed that preoperative diabetes mellitus, low serum albumin level, large blood loss during operation, large blood transfusion during operation, long time peritoneal drainage tube placement and postoperative biliary fistula were the independent risk factors for postoperative infectious complications in patients with hepatocellular carcinoma（ P 〈 0.05 ）. Conclusion Preoperative diabetes mellitus,low serum albumin level, large blood loss during operation, large blood transfusion during operation, long time peritoneal drainage tube placement and postoperative biliary fistula were the independent risk factors for postoperative infectious complications in patients with hepatocellular carcinoma.