肝切除术治疗肝血管瘤患者术后肝功能衰竭的影响因素分析

摘要/Abstract

摘要： 目的观察肝切除术治疗肝血管瘤患者术后肝功能衰竭发生情况,并分析可能导致肝功能衰竭发生的因素,指导未来肝血管瘤肝切除术后肝功能衰竭的防治。方法选取2014年3月至2020年1月扬州友好医院接受肝切除术治疗的96例肝血管瘤患者,观察全部患者术后肝功能衰竭发生情况,设计基线资料调查表,记录患者基线资料并将全部可能的因素纳入分析,经单因素与多因素找出可能导致术后肝功能衰竭的影响因素。结果本研究纳入行肝切除术治疗的96例肝血管瘤患者,术后发生肝功能衰竭9例,发生率为9.38%;经初步基线资料比较,后行单因素分析并建立多元回归模型行多因素分析结果显示,肿瘤体积大、血小板数量低、术中失血量高均是肝血管瘤患者肝切除术后发生肝功能衰竭的影响因素(OR＞1,P<0.05)。结论肝血管瘤患者肝切除术后仍有部分患者存在肝衰竭风险,可能与肿瘤体积大、血小板数量低、术中失血量高有关,临床应重视存在上述肝衰竭风险因素的肝血管瘤患者肝切除术后的合理干预,可能对减少患者肝功能衰竭发生、改善预后有积极意义。

关键词: 肝血管瘤, 肝切除术, 肝功能衰竭, 肿瘤体积, 血小板, 失血量

Abstract: Objective To observe the occurrence of liver failure in patients with hepatic hemangioma after hepatectomy and analyze the risk factors.Methods A total of 96 patients with hepatic hemangioma who underwent hepatectomy in Department of General Surgery, Yangzhou Friendship Hospital from March 2019 to January 2020 were selected in this study. The occurrence of postoperative liver failure in all patients were observed. A baseline data survey form was designed and used for recording the patient’s information. Single and multivariant analyses were performed to identify the risk factors associated with post-hepatectomy liver failure.Results Nine of the 96 patients (9.38%) with hepatic hemangioma had liver failure after hepatectomy. Single and multivariant regression analyses showed that large tumor size, low platelet count, and high intraoperative blood loss were the risk factors of liver failure after hepatectomy (OR>1, P<0.05).Conclusion Hepatic hemangioma patients have the risk of liver failure after hepatectomy, which may be related to the large tumor size, low platelet count, and high intraoperative blood loss. Clinical attention should be paid to reasonable intervention after hepatectomy in patients with hepatic hemangioma with the above-mentioned risk factors of liver failure for improving their prognosis.

Key words: Hepatic hemangioma, Hepatectomy, Liver failure, Tumor volume, Platelet count, Blood loss

王国峰, 贾玉清, 王洪勃. 肝切除术治疗肝血管瘤患者术后肝功能衰竭的影响因素分析[J]. 肝脏, 2021, 26(8): 887-891.

WANG Guo-feng, JIA Yu-qing, WANG Hong-bo. Risk factors of post-operative liver failure in hepatectomized patients due to hepatic hemangioma[J]. Chinese Hepatolgy, 2021, 26(8): 887-891.

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