Li Xiang-cheng, Yao Ai-hua, Cheng Feng, Zhang Chuan-yong, Li Guo-qiang, Lu Sen, Wang Ke, Qian Xiao-feng, Pu Li-yong, Wang Ping, Xu Yong-hua, Wang Xue-hao
Nanjing Medical University, Nanjing 210029, China.
Zhonghua Wai Ke Za Zhi. 2009 Nov 1;47(21):1616-9.
To evaluate the perioperative clinical outcome and predictive factors for perioperative complication morbidity and mortality.
From August 2003 to August 2008, the data of 338 cases of hepatectomy performed in the liver transplant center of the First Affiliated Hospital of Nanjing Medical University was collected in a prospective manner. The patients' perioperative clinical risk factors and results were analyzed.
In the 338 hepatectomy cases, 255 patients (75.4%) underwent precise anatomical hepatectomy. The overall perioperative complication morbidity was 18.1%, while the perioperative mortality was 0.6%. In a total of 211 (62.4%) cases, the operation was carried out without blood transfusion. Univariate analysis revealed that cirrhotic liver, thrombocytopenia, blood loss in operation > 1000 ml, blood transfusion in operation and several other factors were closely related with the incidence rate of complication. Multivariate logistic regression analysis indicated that thrombocytopenia and perioperative blood transfusion were important independently predictive factors for the occurrence of perioperative complications in hepatectomy.
Precise hepatectomy enables patients to obtain better clinical outcome with low complication morbidity and perioperative mortality. Reducing hemorrhage is an important factor that lead to good clinical results.
评估围手术期临床结局以及围手术期并发症发病率和死亡率的预测因素。
前瞻性收集2003年8月至2008年8月在南京医科大学第一附属医院肝脏移植中心进行的338例肝切除术患者的数据。分析患者围手术期临床危险因素及结果。
在338例肝切除病例中，255例（75.4%）接受了精准解剖性肝切除术。围手术期总体并发症发病率为18.1%，围手术期死亡率为0.6%。共有211例（62.4%）手术未输血。单因素分析显示，肝硬化肝脏、血小板减少、术中失血>1000ml、术中输血等因素与并发症发生率密切相关。多因素logistic回归分析表明，血小板减少和围手术期输血是肝切除术中围手术期并发症发生的重要独立预测因素。
精准肝切除术能使患者获得更好的临床结局，并发症发病率和围手术期死亡率低。减少出血是取得良好临床效果的重要因素。
