肝脏脂肪变性对肝癌患者肝癌切除根治术安全性的影响

发布时间：2018-07-07 11:20

本文选题：肝癌 + 肝癌切除根治术　；参考：《山东医药》2017年13期

【摘要】：目的探讨肝脏脂肪变性对肝癌患者肝癌切除根治术安全性的影响。方法随机抽取接受肝癌切除根治术的肝癌患者269例,其中肝脏无脂肪变性216例(A组),轻度脂肪变性32例(B组),中重度脂肪变性21例(C组)。分别就三组患者手术前临床因素(性别、年龄、BMI、基础疾病、血肌酐、白蛋白、谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素、凝血酶原时间、前清蛋白),手术相关因素(切除肝段数、第一肝门阻断率、第一肝门阻断时间、手术时间、失血量、输注红细胞量),围手术期的生化指标,并发症发生概率及其严重程度,死亡概率,总住院时间、ICU住院时间等进行统计分析。结果 B、C组BMI高于A组(P均0.05);C组手术时间、失血量高于A、B组(P均0.05);C组术后肝脏功能指标明显异常,且波动较大,与术前相比,P均0.05,但与A组对比,P均㧐0.05;B、C组术后并发症发生概率高于A组,但数据对比差异无统计学意义(P均0.05);A、B、C组术后病死率比较,P㧐0.05;C组总住院时间、ICU住院时间均长于A组(P均0.05);A、B组比较,P均0.05;输血及脂肪变性与手术并发症相关[OR(95%CI)分别为13.04(4.77~34.97)、3.75(0.97~14.37),P均0.05]。结论肝癌患者轻度脂肪肝对肝癌切除根治术安全性影响不大,而中重度脂肪肝会加大手术风险。
[Abstract]:Objective to investigate the effect of hepatic steatosis on the safety of hepatectomy in patients with liver cancer. Methods A total of 269 patients with liver cancer underwent radical resection of liver cancer were randomly selected, including 216 patients without fatty degeneration (group A), 32 patients with mild fatty degeneration (group B) and 21 patients with moderate and severe steatosis (group C). The clinical factors (sex, age, BMIs, basic diseases, serum creatinine, albumin, alanine aminotransferase, total bilirubin, direct bilirubin, prothrombin time) were analyzed in three groups. Prealbumin), surgical related factors (number of liver segments removed, first hilar occlusion rate, first hilar occlusion time, operative time, blood loss, transfusion of red blood cells), biochemical indicators of perioperative period, probability of complications and severity, The probability of death and total length of stay in ICU were statistically analyzed. Results the BMI in group B was higher than that in group A (P 0.05), and the blood loss in group C was higher than that in group A (P 0.05). The probability of postoperative complications in group A was higher than that in group A (P < 0.05), but it was higher in group A than in group A (P < 0.05). But there was no significant difference between the two groups (P 0.05). There was no significant difference between the two groups (P 0.05). The total hospitalization time and ICU hospitalization time of group A were significantly longer than that of group A (P 0.05), and the blood transfusion and fatty degeneration were related to the complications of operation [OR (95 CI) was 13.04 (4.77 卤34.97) 3.75 (0.97 卤14.37) P < 0.05]. Conclusion mild fatty liver in patients with liver cancer has little effect on the safety of radical resection of liver cancer, while moderate and severe fatty liver may increase the risk of operation.
【作者单位】：安徽医科大学第一附属医院;
【基金】：安徽省科技厅重点科研资助项目(12070403071)
【分类号】：R735.7

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