肝癌肝部分切除术后并发感染危险因素分析

Analysis of Risk Factors of Infection after Partial Hepatectomy for Hepatocellular Carcinoma

目的探讨肝癌肝部分切除术后并发感染的危险因素。方法选择确诊为肝癌且接受肝部分切除术患者122例作为研究对象,包括肝段切除60例,半肝切除50例,扩大半肝切除12例,调查所有患者的基本资料、手术资料、病理资料、随访资料等,记录并发感染情况与分析危险因素。结果在122例患者中,术后并发感染18例,感染率为14. 8%。感染患者与非感染患者的ALB、糖尿病、腹腔引流管留置时间、术中输血量、肝功能分级等指标对比有明显差异(P <0. 05)。Logistic多元回归模型进行分析结果显示ALB、糖尿病、腹腔引流管留置时间、术中输血量为影响术后感染的独立危险因素(P <0. 05)。感染患者的住院时间与住院费用分别为(36. 44±12. 38) d和(78294. 22±11443. 29)元,都明显高于非感染患者的(23. 49±8. 19) d和(48932. 95±7891. 42)元(P <0. 05)。结论肝癌肝部分切除术后并发感染比较常见,可导致住院时间延长与住院花费增加,ALB、糖尿病、腹腔引流管留置时间、术中输血量为主要的危险因素。

Objective To investigate the risk factors of infection after partial hepatectomy for hepatocellular carcinoma. Methods 122 patients with hepatocellular carcinoma by partial hepatectomy were selected,including liver resection of 60 cases,hepatic resection of 50 cases,extended hepatectomy of 12 cases,the basic information,surgical data,pathological data and follow-up data were analyzed.Recorded and analyzed the risk factors of infection. Results In the 122 patients,there were 18 cases of infection,the infection rate was 14.8%.There were significant differences between the infected patients and the non infected patients in ALB,intraoperative blood transfusion volume,indwelling time of the abdominal drainage tube,diabetes and liver function classification（ P〈0.05）.Logistic multivariate regression analysis showed that ALB,intraoperative transfusion volume,indwelling time of abdominal drainage tube and diabetes were the independent risk factors for postoperative infection（ P〈0.05）.The hospitalization time and hospitalization expenses of infected patients were （36.44±12.38）d and （78294.22±11443.29）RMB,respectively,which were significantly higher than （23.49±8.19）d and （48932.95±7891.42）RMB（ P〈0.05） in non infected patients. Conclusion The infection after partial hepatectomy for hepatocellular carcinoma is more common,it can lead to prolong hospitalization and increase hospitalization costs,the ALB,intraoperative transfusion volume,indwelling time of abdominal drainage tube and diabetes are the main risk factors for infection.