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肝癌患者肝移植术后腹腔内细菌感染的危险因素。

Risk factors of intra-abdominal bacterial infection after liver transplantation in patients with hepatocellular carcinoma.

机构信息

1 The 175th hospital of PLA, Zhangzhou 363000, China ; 2 Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Chang-Hai road 225, Shanghai 200438, China.

出版信息

Chin J Cancer Res. 2014 Jun;26(3):309-14. doi: 10.3978/j.issn.1000-9604.2014.06.10.

Abstract

OBJECTIVE

To explore the risk factors of intra-abdominal bacterial infection (IAI) after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC).

METHODS

A series of 82 HCC patients who received LT surgeries in our department between March 2004 and April 2010 was recruited in this study. Then we collected and analyzed the clinical data retrospectively. Statistical analysis system (SPSS) software was adopted to perform statistical analysis. Chi-square test, t-test and Wilcoxon rank sum test were used to analyze the clinical data and compute the significance of the incidences of early-stage IAI after LT for HCC patients. Binary logistic regression was performed to screen out the risk factors, and multiple logistic regression analyses were performed to compute the independent risk factors.

RESULTS

A series of 13 patients (13/82, 15.9%) had postoperative IAI. The independent risk factors of postoperative intra-abdominal bacterial infections after LT for HCC patients were preoperative anemia [Hemoglobin (HGB) <90 g/L] and postoperative abdominal hemorrhage (72 hours >400 mL), with the odds ratios at 8.121 (95% CI, 1.417 to 46.550, P=0.019) and 5.911 (95% CI, 1.112 to 31.432, P=0.037).

CONCLUSIONS

Postoperative IAI after LT in patients with HCC was a common complication. Preoperative moderate to severe anemia, as well as postoperative intra-abdominal hemorrhage more than 400 mL within the first 72 hours might independently indicate high risk of IAI for these patients.

摘要

目的

探讨肝细胞癌(HCC)患者肝移植(LT)后发生腹腔内细菌感染(IAI)的危险因素。

方法

本研究纳入了 2004 年 3 月至 2010 年 4 月期间在我科接受 LT 手术的 82 例 HCC 患者。然后,我们回顾性收集和分析了临床资料。采用统计分析系统(SPSS)软件进行统计分析。采用卡方检验、t 检验和 Wilcoxon 秩和检验分析临床资料,计算 HCC 患者 LT 后早期 IAI 发生率的显著性。采用二项逻辑回归筛选危险因素,采用多元逻辑回归分析计算独立危险因素。

结果

共有 13 例(13/82,15.9%)患者术后发生 IAI。HCC 患者 LT 术后腹腔内细菌感染的独立危险因素为术前贫血[血红蛋白(HGB)<90 g/L]和术后腹部出血(72 小时>400 mL),其比值比(OR)分别为 8.121(95%可信区间,1.417 至 46.550,P=0.019)和 5.911(95%可信区间,1.112 至 31.432,P=0.037)。

结论

HCC 患者 LT 后发生 IAI 是一种常见的并发症。术前中重度贫血,以及术后 72 小时内腹腔内出血超过 400 mL,可能独立提示这些患者发生 IAI 的风险较高。

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