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目的研究与肝癌切除术后并发症发生有关的因素,并探讨减少肝癌切除术后并发症的技术要点。方法回顾性总结1988年6月至2005年4月间连续施行的378例肝癌切除病例,采用单因素分析和多元逐步回归模型分析与肝癌切除术后并发症有关的因素。结果肝癌切除术后总的并发症发生率为17.7%,手术死亡率为1.3%。单因素分析显示,年龄、肝门阻断、出血量以及术中输血等4项指标与并发症发生有关。多元逐步回归分析显示年龄、肝门阻断和术中输血这3项指标是决定肝癌切除术后并发症发生的独立的危险因素。结论降低肝癌切除术后并发症发生率的关键在于术中有效地控制出血及输血量,同时对伴存肝硬化的病人应尽量缩短肝门阻断时间。
Objective To study the factors related to the occurrence of complications after resection of liver cancer and to discuss the technical points of reducing the complications after resection of liver cancer. Methods A total of 378 cases of HCC resected between June 1988 and April 2005 were retrospectively reviewed. Univariate and multivariate stepwise regression models were used to analyze the factors related to postoperative complications of HCC. Results The overall complication rate after hepatectomy was 17.7% and the operative mortality rate was 1.3%. Univariate analysis showed that age, hepatic portal obstruction, blood loss and intraoperative blood transfusion and other four indicators related to complications. Multivariate stepwise regression analysis showed that age, portal vein occlusion and intraoperative blood transfusion were the three independent risk factors for the postoperative complications of hepatocellular carcinoma. Conclusions The key to reducing the incidence of postoperative complications of liver cancer resection is to effectively control the amount of blood transfusion and blood transfusion during operation, and to minimize the time of hepatic portal vein occlusion in patients with cirrhosis.