Wang Xianfeng, Lv Qiaohong, Meng Zhangge
Department of Hepatobiliary Surgery, Xinchang People's Hospital, Shaoxing, 312500, Zhejiang Province, China.
Department of Hepatobiliary Surgery, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, 311800, Zhejiang Province, China.
Cell Mol Biol (Noisy-le-grand). 2023 May 31;69(5):87-93. doi: 10.14715/cmb/2023.69.5.15.
To investigate related factors of liver abscess associated with hepatobiliary ischemic necrosis after cholangiocarcinoma surgery, 100 patients with cholangiocarcinoma requiring surgical resection were collected and divided into a test group (53 patients with liver abscess) and a control group (47 patients without liver abscess) according to presence or absence of liver abscess. Related factors were compared: gender, age, body mass index (BMI), body temperature at admission, duration of medical history, presence or absence of a history of diabetes, time of medical history, presence or absence of hepatolithiasis, absolute neutrophil count, absolute lymphocyte count (ALC), C-reactive protein, serum albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP), direct bilirubin (DBIL), serum creatine, and presence or absence of anemia. Univariate analysis showed that BMI, age, gender, absolute lymphocyte count, serum ALB, AST, and time of medical history were significantly different between the two (P<0.05). Multivariate logistic regression analysis of the above influencing factors showed that independent influencing factors of postoperative liver abscess formation were: ALC<1.1*10^9/L (P<0.001, OR=23.459, 95% CI=8.529-64.576), AST≥40 U/L (P=0.012, OR=3.946, 95% CI=1.355-11.487), time of medical history≥21 days (P=0.010, OR=4.028, 95% CI=1.389-11.681). Decreased ALC, increased AST, and occurrence of acute biliary tract infection were independent factors for hepatobiliary ischemic necrosis-related liver abscess. Abnormal nutritional status, age, and gender were also the influencing factors of liver abscess.
为探讨胆管癌术后肝脓肿合并肝胆缺血坏死的相关因素,收集100例行手术切除的胆管癌患者,根据有无肝脓肿分为试验组(53例有肝脓肿患者)和对照组(47例无肝脓肿患者)。比较相关因素:性别、年龄、体重指数(BMI)、入院体温、病史时长、有无糖尿病史、病史时间、有无肝内胆管结石、中性粒细胞绝对值、淋巴细胞绝对值(ALC)、C反应蛋白、血清白蛋白(ALB)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(AKP)、直接胆红素(DBIL)、血清肌酐以及有无贫血。单因素分析显示,两组间BMI、年龄、性别、淋巴细胞绝对值、血清ALB、AST及病史时间差异有统计学意义(P<0.05)。对上述影响因素进行多因素logistic回归分析,结果显示术后肝脓肿形成的独立影响因素为:ALC<1.1×10^9/L(P<0.001,OR=23.459,95%CI=8.529 - 64.576)、AST≥40 U/L(P=0.012,OR=3.946,95%CI=1.355 - 11.487)、病史时间≥21天(P=0.010,OR=4.028,95%CI=1.389 - 11.681)。ALC降低、AST升高及急性胆道感染的发生是肝胆缺血坏死相关肝脓肿的独立因素。营养状况异常、年龄及性别也是肝脓肿的影响因素。