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肝细胞癌药物洗脱经动脉化疗栓塞术后感染危险因素分析:一项回顾性研究。

Analysis of risk factors for post-operative infection following drug-eluting trans arterial chemo embolization in hepatocellular carcinoma: A retrospective study.

作者信息

Wang Gang, Qi Rui

机构信息

Department of Intervention, The First Hospital of Anhui University of Science and Technology, Huainan 232007, Anhui Province, China.

出版信息

World J Gastrointest Surg. 2025 Jun 27;17(6):106276. doi: 10.4240/wjgs.v17.i6.106276.

Abstract

BACKGROUND

Post-operative infection is a common and serious complication following drug-eluting trans arterial chemo embolization (D-TACE) in patients with hepatocellular carcinoma (HCC), potentially compromising treatment efficacy and increasing morbidity.

AIM

To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE, and to provide evidence for clinical prevention and targeted intervention strategies.

METHODS

Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed. Patient demographics, laboratory test results, tumor characteristics, and surgery-related parameters were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.

RESULTS

Post-operative infection occurred in 20 cases (25.97%) among the 77 patients. Univariate analysis showed that age ≥ 65 years, Child-Pugh grade B, tumor diameter ≥ 5 cm, operation time ≥ 120 minutes, preoperative albumin < 35 g/L, and comorbid diabetes were significantly associated with post-operative infection ( < 0.05). Multivariate logistic regression analysis identified Child-Pugh grade B (OR = 2.851, 95%CI: 1.426-5.698), operation time ≥ 120 minutes (OR = 2.367, 95%CI: 1.238-4.523), and preoperative albumin < 35 g/L (OR = 2.156, 95%CI: 1.147-4.052) as independent risk factors for post-operative infection.

CONCLUSION

Liver function status, operation time, and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE. For high-risk patients, enhanced perioperative management, appropriate timing of surgery, and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.

摘要

背景

术后感染是肝细胞癌(HCC)患者接受药物洗脱经动脉化疗栓塞术(D-TACE)后常见且严重的并发症,可能会影响治疗效果并增加发病率。

目的

探讨接受D-TACE的HCC患者术后感染的相关危险因素,为临床预防和针对性干预策略提供依据。

方法

回顾性分析2022年1月至2023年12月在我院接受D-TACE的77例原发性HCC患者的临床资料。收集患者的人口统计学资料、实验室检查结果、肿瘤特征和手术相关参数。进行单因素和多因素逻辑回归分析以确定术后感染的危险因素。

结果

77例患者中有20例(25.97%)发生术后感染。单因素分析显示,年龄≥65岁、Child-Pugh B级、肿瘤直径≥5 cm、手术时间≥120分钟、术前白蛋白<35 g/L以及合并糖尿病与术后感染显著相关(<0.05)。多因素逻辑回归分析确定Child-Pugh B级(OR = 2.851,95%CI:1.426 - 5.698)、手术时间≥120分钟(OR = 2.367,95%CI:1.238 - 4.523)和术前白蛋白<35 g/L(OR = 2.156,95%CI:1.147 - 4.052)为术后感染的独立危险因素。

结论

肝功能状态、手术时间和术前白蛋白水平是影响接受D-TACE的HCC患者术后感染的重要因素。对于高危患者,应加强围手术期管理,选择合适的手术时机,并积极改善营养状况以降低术后感染风险。

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