Xing Xue, Li Hong, Liu Wei-Guo, Xia Sui-Sheng, Chen Xiao-Ping
Department of Hepatobiliary Surgery, Qingdao Municipal Hospital, Qingdao 266011, China.
Hepatobiliary Pancreat Dis Int. 2004 Aug;3(3):402-5.
This study was to clarify the high risk factors for subphrenic infection (SI) after liver resection for patients with hepatic malignancy.
Three hundred and sixty-eight patients who had undergone hepatectomy from January 1985 through June 2002 were randomly divided into 2 groups according to resection of liver parenchyma, hepatic cirrhosis, primary liver cancer, intraoperative blood loss, and subphrenic drainage. The chi-square was used for statistical analysis.
Thirteen patients (3.53%) of the 368 patients had SI. The high-risk factors for SI after hepatectomy were related to resection of liver parenchyma and hepatic cirrhosis; but the course or stage of primary liver cancer was not related to the incidence of SI. Intraoperative blood loss of over 1500 ml was found to be a significant risk factor for postoperative SI. Adequate drainage of the subdiaphragm and the raw surface of the liver after operation was essential to decreasing SI after liver resection.
Inadequate subphrenic drainage may largely contribute to SI in patients with hepatic malignancy undergoing hepatectomy apart from other factors. Comprehensive measures should be taken to prevent the infection after hepatectomy.
本研究旨在阐明肝恶性肿瘤患者肝切除术后膈下感染（SI）的高危因素。
将1985年1月至2002年6月期间接受肝切除术的368例患者，根据肝实质切除、肝硬化、原发性肝癌、术中失血及膈下引流情况随机分为2组。采用卡方检验进行统计学分析。
368例患者中有13例（3.53%）发生SI。肝切除术后SI的高危因素与肝实质切除及肝硬化有关；但原发性肝癌的病程或分期与SI的发生率无关。术中失血超过1500 ml是术后SI的一个重要危险因素。术后充分引流膈下及肝创面对于减少肝切除术后SI至关重要。
除其他因素外，膈下引流不充分可能在很大程度上导致接受肝切除术的肝恶性肿瘤患者发生SI。应采取综合措施预防肝切除术后感染。
