Du Zhaoqing, Dong Jian, Zhang Jia, Bi Jianbin, Wu Zheng, Lv Yi, Zhang Xufeng, Wu Rongqian
Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China; Institute of Advanced Surgical Technology and Engineering, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China; Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
J Surg Res. 2018 Feb;222:69-74. doi: 10.1016/j.jss.2017.09.045. Epub 2017 Nov 1.
Postoperative complications after splenectomy are not rare and can be serious in cirrhotic patients. The purpose of this study was to assess postoperative complications using the comprehensive complication index (CCI) after splenectomy in cirrhotic patients and identify risk factors for those who developed a high postoperative CCI score.
This retrospective study included 208 adult patients with viral hepatitis-related cirrhosis, who underwent elective splenectomy at our hospital from January 2002 to June 2012. The primary outcome was the CCI score. A CCI score >30 was considered to be a high CCI score.
The median CCI score in this cohort was 25.6 (range: 8.7-62.9), and 66 patients (31.7%) had a CCI score >30. Univariable and multivariable analyses showed that the risk factors independently associated with a high CCI score were a history of hypertension and a model for end-stage liver disease (MELD) score ≥10 prior to splenectomy.
A high CCI score is common in cirrhotic patients undergoing splenectomy. The CCI is a useful grading system to assess postoperative morbidity in cirrhotic patients undergoing splenectomy. Preoperative blood pressure control is recommended and cirrhotic patients with an elevated MELD score should consider other treatment options for hypersplenism.
脾切除术后的并发症并不罕见，在肝硬化患者中可能会很严重。本研究的目的是使用综合并发症指数（CCI）评估肝硬化患者脾切除术后的并发症，并确定术后CCI评分高的患者的危险因素。
这项回顾性研究纳入了2002年1月至2012年6月在我院接受择期脾切除术的208例成人病毒性肝炎相关肝硬化患者。主要结局指标是CCI评分。CCI评分>30被认为是高CCI评分。
该队列的中位CCI评分为25.6（范围：8.7 - 62.9），66例患者（31.7%）的CCI评分>30。单因素和多因素分析表明，与高CCI评分独立相关的危险因素是高血压病史和脾切除术前终末期肝病模型（MELD）评分≥10。
高CCI评分在接受脾切除术的肝硬化患者中很常见。CCI是评估接受脾切除术的肝硬化患者术后发病率的有用分级系统。建议术前控制血压，MELD评分升高的肝硬化患者应考虑其他脾功能亢进的治疗选择。
