肝癌患者肝切除术后感染并发症相关危险因素的分析1.docVIP

肝癌患者肝切除术后感染并发症相关危险因素分析 【摘要】目的 探讨。方法=33）和正常组（n=184），对可能引起感染并发症的因素进行统计学统计分析。 结果 结论 【关键词】；；； Risk factors for postoperative infectious complications after hepatectomy for hepatocellular carcinoma 【Abstract】 Objective To explore the risk factors for postoperative infectious complications after hepatectomy in hepatocellular carcinoma patients. Methods The clinical data of 217 hepatocellular carcinoma patients after hepatectomy admitted to our hospital from 2006 to 2012 were retrospectively analyzed. After classification into 2 groups depending on the occurrence of postoperative infectious complications, the risk factors that may cause infectious complications were treated with statistical analysis. Results In our study, the incidence of postoperative infection was 15.21% (33/217), and the surgical site infection in15 cases (45.45%), the surface of the liver infection in 4 cases (12.12%), the remote infections in 14 cases (42.42%). The surgical mortality was 1.38% (3/217). Multiple Logistic regression analysis showed the independent risk factors for postoperative infectious complications after hepatectomy included age (P=0.006, OR=2.564), history of diabetes (P =0.02, O =1.996), operative time (P=0.005, OR=2.237) and bile leakage rate (P0.001, OR=7.325). Conclusion Age, history of diabetes, operative time and bile leakage are the independent risk factors for postoperative infectious complications after hepatectomy. 【Key words】epatocellular carcinoma; hepatectomy; infection; risk factors 肝癌是临床上最常见的恶性肿瘤之一，主要为原发性肝癌，在世界范围内其发病率和死亡率都排在全部恶性肿瘤中的前列。根据全国第三次肿瘤死亡报告死因回顾抽样调查结果显示[1]，我国肝癌死亡位居所有恶性肿瘤死因的第2位，占19.33%。在临床中，肝切除术已被广泛应用于治疗多种肝脏疾病，尤其成为治疗肝癌的首选措施[2]。随着肝胆外科水平的发展及围手术期治疗措施的进步，肝切除术后的死亡率在近年来已降至5%以下[3,4]。然而，由于肝癌常与其它慢性肝脏疾病、糖尿病等相关，且手术创伤较大，因此肝切除术后的并发症率仍高达18.9%～53.3%[5,6] ，这导致了患者住院时间延长，经济和精神负担增加。 肝癌肝切除术后并发症主要是感染性并发症，主要包括手术部位感染、肝脏周围感染及远处部位感等[7]，因此降低术后感染率，提高患者生存率已成为临床肝脏外科学医生急需解决的问题。有关肝癌肝切除术后感染并发症相关危险因素的分析，目前国内甚少见文献报道。本研究回顾性分析了我院6年来217例行肝切除术的肝癌患者临床资料，旨在于探讨肝切除治疗肝癌术后并发症发生相关的危险因素。 一、临床资料 从2006年4月至