69例肝切除术后肝功能失代偿主要风险分析

Risk Factor Analysis of Liver Function Discompensation After Hepatectomy

目的:研究肝切除术后肝功能失代偿的主要风险因素。方法:对69例肝切除手术患者,分别施行肝段、叶、半肝及肝三叶切除,其中半肝切除18例,肝三叶切除5例。分析术后肝功能失代偿与临床病理参数的关系。结果:17例出现术后肝功能失代偿,发生率24.64%,其中4例死于肝功能衰竭,死亡率5.79%。术前肝硬化程度、Child分级、AST、ALT、GGT、TBIL、CHE及术后首日腹腔引流(FDAD)、CHE与术后肝功能失代偿的发生具有明显相关性;与血清白蛋白、肝切除量、肝门阻断时间、术中出血量无关。结论:评估肝切除术后肝功能失代偿的危险性需结合肝功能化验指标综合分析,肝硬化程度和胆碱酯酶(CHE)是主要的、较好的评估指标。

Objective:to observe the main risk factors related to liver function discompen-sa tion after hepatectomy.Methods:retrospective analysis of69patients conduct hepatectomy:seg-men tal resection,lobectomy,hemi-hepatectomy and tri-lobectomy.The main clinical risk factors and laboratorial result were analyzed.Results:totally17cases occurred discompensation after hepatectomy and4of them died of liver function failure.The mortality rate is5.79%.Liver cir-rhosis,Child grade,first day abdomen drainage,AST,ALT,GGT,TBIL,CHE,post operative CHE reach the statistical significance while the serum albumin,resection volume,bloke time,operative bleed ing don't have the statistical significance.Conclusion:to evaluate the risk of liver function dis compensation after hepatectomy need comprehensive analysis of different clinical and laboratori-al parameters while the liver cirrhosis and CHE are the main and important factors.