关键词: 泡型肝包虫病, 肝切除, 肝衰竭, Logistic模型, 一致性分析

Abstract: Objective To investigate the predictors of the risk of liver failure after hepatectomy in patients with hepatical alveolar echinococcosis. Methods A total of 159 patients with hepatical alveolar echinococcosis who underwent hepatectomy in our hospital from April 2017 to April 2020 were included in the study. The patients were divided into hepatic failure group (n=38) and non-hepatic failure group (n=121) according to whether liver failure occurred after surgery. We compared two groups of gender, age, living areas, ethnic minority, pathological changes, the standardized residual liver volume (SRLV), Child-Pugh, grading, focal diameter, operation time, intraoperative blood loss, then the statistically significant factors above were included in the logistic model and with quantitative assignment, whether with liver failure as the dependent variable (Yes = 1, No = 0), age, SRLV, Child-Pugh grade, operative time, intraoperative blood loss as the independent variable (X), in order to determine the risk factors of liver failure in patients with hepatical alveolar echinococcosis after hepatectomy. Finally, the accuracy of age, SRLV, Child-Pugh grade, operation time and intraoperative blood loss in predicting postoperative liver failure of such patients was analyzed by consistency. Results There was significant difference in gender, residential area, nationality, lesion site and lesion diameter between the two groups (P>0.05). In the liver failure group, the proportion of patients with age ≥ 65 years old, SRLV < 50%, Child-Pugh grade B-C, operation time ≥ 3 h, intraoperative blood loss ≥ 1000 mL were significantly higher than that in the non-liver failure group (P<0.05). Multiple Logistic regression analysis model confirmed that age ≥ 65 years old, SRLV < 50%, Child-Pugh grade B-C, operation time ≥ 3 h, and intraoperative blood loss ≥ 1000 mL were risk factors for liver failure after hepatectomy for patients with hepatical alveolar echinococcosis (P<0.05). Consistency analysis confirmed that age, SRLV, Child-Pugh grade, operative time and intraoperative blood loss could all be used to predict hepatic failure after hepatectomy for patients with hepatical alveolar echinococcosis. Conclusion Logistic model confirmed that the occurrence of liver failure after hepatectomy in patients with hepatical alveolar echinococcosis was closely related to age, SRLV, Child-Pugh grade, operation time, and intraoperative blood loss. Meanwhile, consistency analysis confirmed that the above factors could be used to predict postoperative liver failure in such patients, and the consistency was relatively high.

Key words: Hepatical alveolar echinococcosis, Hepatectomy, Liver failure, Logistic model, Consistency analysis