Chu Kai-Jian, Yao Xiao-Ping, Fu Xiao-Hui
Department of Oncology Comprehensive Treatment, Eastern Hepatobiliary Surgical Hospital, Second Military Medical University, Shanghai 200438, China.
Hepatobiliary Pancreat Dis Int. 2007 Feb;6(1):58-62.
Pleural effusion frequently complicates hepatectomy and multiple factors contribute to its development following hepatectomy for primary liver cancer. The purpose of this study was to evaluate these factors.
From March 2003 to May 2005, 228 consecutive patients with primary liver cancer underwent hepatectomy in our department were evaluated retrospectively to identify factors related to postoperative pleural effusion.
Among the 228 patients, postoperative pleural effusions arose in 58 (25.4%). Univariate analysis showed significant differences in postoperative ascites, subphrenic collection, Pringle manoeuvre length, drainage amount on postoperative day 1, albumin level on postoperative day 7, alanine aminotransferase (ALT) level on postoperative days 1 and 3, prealbumin level on postoperative days 3 and 7, and tumor size (P<0.05). Ordinal regression analysis revealed that subphrenic collection, drainage on postoperative day 1 and ALT plus prealbumin on postoperative days 1 and 3 were statistically significantly related to postoperative pleural effusion (P<0.05).
Subphrenic collection and operative injury to the liver appeared to be significantly related to pleural effusion after hepatectomy for primary liver cancer.
胸腔积液常使肝切除术后病情复杂化,多种因素促成原发性肝癌肝切除术后胸腔积液的发生。本研究旨在评估这些因素。
回顾性分析2003年3月至2005年5月在我科连续接受肝切除术的228例原发性肝癌患者,以确定与术后胸腔积液相关的因素。
228例患者中,58例(25.4%)出现术后胸腔积液。单因素分析显示,术后腹水、膈下积液、Pringle手法持续时间、术后第1天引流量、术后第7天白蛋白水平、术后第1天和第3天丙氨酸转氨酶(ALT)水平、术后第3天和第7天前白蛋白水平以及肿瘤大小存在显著差异(P<0.05)。有序回归分析显示,膈下积液、术后第1天引流量以及术后第1天和第3天的ALT加前白蛋白与术后胸腔积液在统计学上显著相关(P<0.05)。
膈下积液和肝脏手术损伤似乎与原发性肝癌肝切除术后胸腔积液显著相关。