摘要
目的:研究肝硬化合并肝肿瘤患者行肝不规则切除术后再手术的相关因素。方法:回顾性分析2013年6月至2017年6月因肝硬化合并肝癌行不规则肝切除120例患者的病历资料,分析患者再手术情况以及各种术前、术后、术中因素与进行再手术的相关性。结果:本次研究对象再手术率8. 33%,再手术患者肝创面出血6例,腹腔感染3例,肿瘤复发1例,死亡病例1例;再手术率与患者术前血清ALB水平、术前是否合并糖尿病、术中出血量、术后引流管留置时间有关(P <0. 05),与患者的年龄、性别、术前血清AST、TBIL水平、术前是否合并高血压和COPD、手术花费和手术时间、术后住院时间和术后输注白蛋白总量无关(P> 0. 05)。结论:肝硬化合并肝肿瘤患者行肝不规则切除术后再手术的主要原因为肝创面出血、腹腔感染、肿瘤复发,其中肝创面出血最常见;患者术前血清ALB水平降低、术前合并糖尿病、术中出血量≥500 m L、术后引流管留置时间≥7 d是再手术的相关因素。
Objective:To study the related factors of reoperation after irregular hepatectomy in patients with liver cirrhosis combined with liver tumor.Methods:The medical records of 120 patients who underwent irregular liver resection due to cirrhosis and liver cancer from June 2013 to June 2017 were retrospectively analyzed,and the patients'situation of reoperation and the correlation between the patients'reoperation and various preoperative,postoperative and intraoperative factors were analyzed.Results:In this study,the reoperation rate was 8.33%,and there were 6 cases of liver wound bleeding in patients with reoperation,3 cases of abdominal infection,1 case of tumor recurrence,and 1 case of death.The reoperation rate was related to the patients'preoperative serum ALB level,preoperative diabetes,intraoperative blood loss,and postoperative catheter retention time(P<0.05).But the reoperation rate was not correlated with the patients'age,gender,preoperative serum AST,TBIL level,preoperative concomitant hypertension and chronic obstructive pulmonary disease(COPD),surgical cost and operation time,postoperative hospitalization time and postoperative total albumin infusion(P>0.05).Conclusion:The main reasons for the reoperation of hepatocirrhosis complicated with liver tumor are liver wound bleeding,abdominal infection,and tumor recurrence,among which liver wound hemorrhage is the most common reason.Preoperative decrease in serum ALB level,preoperative complicated diabetes mellitus,intraoperative blood loss equal to or more than 500ml,postoperative drainage tube retention time equal to or more than 7d are related factors for reoperation.
作者
钟波
朱巧珍
刘小裕
ZHONG Bo;ZHU Qiaozhen;LIU Xiaoyu(Department of Hepatobiliary Surgery,The People's Hospital in Nanshan District of Shenzhen,Shenzhen 518052,China;The People's Hospital in Bao'an District of Shenzhen)
出处
《包头医学院学报》
CAS
2018年第11期16-18,共3页
Journal of Baotou Medical College
关键词
肝硬化
原发性肝癌
肝不规则切除术
再手术
相关因素
Liver cirrhosis
Primary liver cancer
Liver irregular resection
Reoperation
Related factors
