肝癌患者术后发生胸腔积液的影响因素

Influencing Factors of Postoperative Pleural Effusion in Patients with Liver Cancer

目的分析肝癌患者术后发生胸腔积液的影响因素。方法选取2018年11月至2021年11月商丘市长征人民医院收治的170例肝癌患者作为研究对象,所有患者均行肝切除术治疗,术后3d统计所有患者术后胸腔积液发生情况并分组,询问并记录所有患者基线资料,设计基线资料填写表,将可能的影响因素纳入,找出肝癌患者术后发生胸腔积液的影响因素。结果170例肝癌患者行肝切除术后,有39例发生胸腔积液,占比为22.94%;发生组术后服用利尿剂患者占比低于未发生组,发生组术前肿瘤直径大于未发生组,第一肝门阻断时间长于未发生组,术后24h液体量多于未发生组(P<0.05);两组性别、年龄、术前肝功能Child-Pugh分级、肝癌TNM分期、合并2型糖尿病等基线资料比较,差异无统计学意义(P>0.05)。经logistic回归分析,结果显示,术前肿瘤直径较大、第一肝门阻断时间较长、术后24h液体量较多、术后未服用利尿剂是肝癌患者术后发生胸腔积液的危险因素(OR>1,P<0.05)。结论肝癌患者术后发生胸腔积液可能与术前肿瘤直径较大、第一肝门阻断时间较长、术后24h液体量较多、术后未服用利尿剂有关。

Objective To analyze the influencing factors of postoperative pleural effusion in patients with liver cancer.Methods A total of 170 patients with liver cancer treated in Shangqiu Changzheng People’s Hospital from November 2018 to November 2021 were selected as the research objects,and all patients underwent hepatectomy.Three days after operation,the occurrence of postoperative pleural effusion in all patients was counted and divided into groups,asked and recorded the baseline data of all patients,then designed the baseline data filling form,and included possible influencing factors.The influencing factors of postoperative pleural effusion in patients with liver cancer were found out.Results After hepatectomy,pleural effusion occurred in 39 of 170 patients with liver cancer,accounting for 22.94%.Compared with the non occurrence group,the proportion of patients taking diuretics after operation was lower,the tumor diameter before operation was larger,the blocking time of the first hilar was longer and the volume of fluid 24 hours after operation was more in the occurrence group(P<0.05).There was no statistical difference in baseline data of gender,age,preoperative liver function Child-Pugh grading,TNM stage of liver cancer,and type 2 diabetes mellitus between the two groups(P>0.05).The results of logistic regression analysis showed that,the risk factors of pleural effusion in patients with liver cancer were large preoperative tumor diameter before operation,long blocking time of the first hilar,large volume of fluid 24 hours after operation and the absence of diuretics after operation(OR>1,P<0.05).Conclusion The occurrence of pleural effusion in patients with liver cancer may be related to the large diameter of the tumor before operation,the long blocking time of the first hepatic portal,the large volume of fluid 24 hours after operation and the absence of diuretics after operation.