肝硬化合并肝肿瘤患者不规则肝切除术后再手术的相关因素研究

Study on the Related Factors of Reoperation After Liver Resection in Patients With Liver Cirrhosis Complicated with Liver

目的研究导致肝硬化合并肝肿瘤患者行不规则肝切除术后再手术的相关因素。方法回顾性分析2012年2月至2016年2月期间在我院外科行不规则性肝切除术的152例肝硬化合并肝肿瘤患者的临床资料。根据患者是否再次手术,分为再手术组和非再手术组。分析患者再手术情况及相关临床参数,行Logistic回归分析再手术的相关危险因素。结果肝硬化合并肝肿瘤患者,再手术率为13.2%(20/152)。再手术的主要原因为切口裂开6例,腹腔出血10例;腹腔感染4例,其中合并胆瘘1例。再手术组术前ALB水平低于非再手术组,术前合并有糖尿病、术中出血量水平及术中血浆输入量均高于非再手术组,两组比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,术前合并有糖尿病、ALB水平<35 g/L以及术中出血量≥500 m L者与行不规则肝切除术后再次手术的发生密切相关(P<0.05)。结论术前合并有糖尿病、ALB水平<35 g/L以及术中出血量≥500 m L者是行不规则肝切除术后再次手术的独立危险因素。

Objective Study related to liver cirrhosis with liver cancer patients after irregular liver resection of the relevant factors.MethodsWe retrospectively analyzed the clinical data of152patients with liver cirrhosis complicated with liver cancer who underwent irregular hepatectomy from February2012to February2016in our hospital.According to whether the patient re-opera原tion,divided into re-operation group and non-re-operation group.The mean age was(58.3依19.7years old.There were132cases of non-reoperation group,78males and54females with an average age of(62.5依10.5years.To analyze the reoperation of the patients,and the relevant clinical parameters,logistic regression analysis of re-operation of the relevant risk factors.ResultsCirrhosis with liver tumors in patients with reoperation rate was13.2%(20/152).The main causes of reoperation were incision dehiscence in6cases,in原traperitoneal hemorrhage in10cases,abdominal infection in4cases,with biliary fistula in1case.The preoperative alb level of theReoperation group was lower than that of the non-reoperation group,the level of diabetes and intraoperative bleeding was higher than that in the Non-surgical group,and the difference between the two groups was statistically significant(P约0.05).Logistic regres原sion analysis showed that patients with diabetes mellitus,ALB level<35g/L and intraoperative blood loss逸500ml were closely re原lated to the recurrence of irregular hepatectomy(P约0.05).ConclusionPreoperative merger with diabetes,ALB levels<35g/L and in原traoperative blood loss逸500ml were irregular liver resection after surgery for independent risk factors.