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肝部分切除患者术后并发感染的相关影响因素分析 被引量:3

Risk factors of infections in hepatic cancer patients after partial hepatectomy
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摘要 目的探讨肝部分切除患者术后感染的影响因素,为预防肝切除术后感染的发生提供理论依据。方法回顾性分析2007年12月至2012年12月210例诊断为肝癌行肝部分切除患者的临床资料,将其分为感染组和非感染组,比较2组相关临床资料,采用logistic逐步回归法进行统计学分析,筛选影响术后感染的关键性变量。结果肝部分切除术后有30例感染,感染率为14.3%。患者的年龄、手术时间、失血量、有无输血及有无肝硬化,2组比较差异均有统计学意义(P<0.05)。logistic回归分析显示,患者的年龄、手术时间、失血量、有输血及肝硬化是肝部分切除术后感染的关键危险因素。结论年龄大于等于60岁、手术时间大于等于5 h、失血量大于等于3 000 mL、有输血及合并肝硬化是肝部分切除术后感染并发症的关键危险因素。 Objective To investigate risk factors of infections in hepatic cancer patients after partial hepatectomy so as to provide theo- retical basis for the prevation of infections after the hepatecomy. Methods A total of 210 patients who underwent partial hepatectomy from December 2007 to December 2012 were divided into the infection group and the non-infection group, and they were retrospectively reviewed. Multivariate analysis was performed with logistic regression test. Results Totally 30 patients were infected after operation, and the incidence of infection was 14.9%. There were singinficant difference between age,operation time,blood loss ,blood transfusion and cirrhosis in the two groups(P 〈 0.05 ). Multivariate logistic regression analysis showed that the age, operation time, blood loss, blood transfusion and cirrhosis were significant risk factors for the infections after partial hepatecomy. Conclusion Aged over 60 years, operation time more than 5 hours, blood loss more than 3 000 mL, blood transfusion and cirrhosis were the key risk factors for the infections after partial hepatecomy.
出处 《局解手术学杂志》 2014年第3期280-281,共2页 Journal of Regional Anatomy and Operative Surgery
关键词 肝部分切除术 感染 危险因素 partial hepatectomy infection risk factor
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  • 1许连香,刘朝华,刘小兰.长期住院的老年患者医院感染调查[J].中国新医药,2004,3(7):123-123. 被引量:3
  • 2Godfrey H. Older people, continence care and catheters:dilemmasand resolutions [ J ]. Br J Nurs,2008,17 (9) : s4-11.
  • 3Beukinga I, Rodriguez VH. Management of long-term catheter-related Bre-vibacterum bacteraemia [ J ]. Clin Microbiol Infect,2004,10 ( 5 ) : 465 -467.
  • 4Uenishi T,Hamba H,Takemura,et al.Outcomes of hepaticresectiom for hepatolithiasis[J].Am J Surg,2009,19(8):199-202.
  • 5叶任高.内科学[M]5版[M].北京:人民卫生出版社,2000.961.
  • 64.消化道出血的观察:对术后每次大便的性状、颜色进行肉眼观察,并注意有无呕血现象。 结果 1.肝切除术后FPP变化规律:全组术后FPP均逐渐升高,术后3-7d达顶峰,之后逐渐缓慢下降,但始终不能恢复到肝切除前FPP水平(表1)。2.FPP的升高程度及回落状态与肝切除范围、肝门阻断时间长短及肝硬化程度之间的联系:肝切除范围越小、肝门阻断时间越短、肝硬化程度越轻,术后FPP的升高幅度越小,其回落速度越快且易恢复至切除前水平;相反,肝切除范围越大、肝门阻断时间越长、肝硬化程度越重,术后FPP的升高幅度越大,其回落速度越慢且难以恢复至切除前水平(详见表1-表3)。 表1不同肝硬化程度病人肝切除术后各阶段FPP动态变化
  • 7Jemal A, Siegel R, Xu J,et al. Cancer statistics, 2010[J]. CA Cancer J Clin,2011,60(5) :277-300.
  • 8Neeff H, Makowiec F, Harder J, et al. Hepatic resection for hepatocellular carcinoma-results and analysis of the current litera- ture[J]. Zentralbl Chir, 2009, 134(2) :127-135.
  • 9Vogel TR, Dombrovskiy VY, Graham AM,et al. The im- pact of hospital volume on the development of infectious com- plications after elective abdominal aortic surgery in the Medi-care population[J]. Vasc Endovascular Surg, 2011,45 (4) 317-324.
  • 10Bucher BT, Warner BW, Dillon PA. Antibiotic prophylaxis and the prevention of surgical site infection[J]. Curr Opin Pediatr, 2011,23 (3) :334-338.

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  • 1黄长玉,黄建富,陈燕凌,沈娟,蔡欣然,周浩辉.原发性肝细胞癌合并门静脉癌栓的外科治疗[J].肝胆外科杂志,2005,13(4):253-256. 被引量:3
  • 2Lurje G, Lesurtel M, Clavien PA. Multimodal treatment strategies in patients undergoing surgery for hepatocellular carcinoma [ J ]. Dig Dis, 2013,31 ( 1 ) :112-117. DOI:10. 1159/000347205.
  • 3Wu KT, Wang CC, Lu LG, et al. Hepatocellular carcinoma: clinical study of long-term survival and choice of treatment modalities [ J]. World J Gastroenterol, 2013,19(23) :3649-3657. 130I:10. 3748/wiz. v19. i23. 3649.
  • 4Kobayashi S, Gotohda N, Nakagohri T, et al. Risk factors of surgical site infection after hepatectomy for liver cancers[ J]. World J Sur, 2009,33 (2) :312-317. DOI : 10. 1007/s00268-008-9831-2.
  • 5Kokudo T, Uldry E, Demartines N, et al. Risk factors for incisional and organ space surgical site infections after liver resection are different[J]. World J Sur, 2015,39(5) :1185-1192. DOI: 10. 1007/s00268-014-2922-3.
  • 6Moreno Elolalaso A, Davenport DL, Hundley JC, et al. Predictors of surgical site infection after liver resection: a multicentre analysis using National Surgical Quality Improvement Program data [J]. HPB, 2012,14(2) :136-141. DOI:10. 1111/j. 1477-2574. 2011. 00417. x.
  • 7Okabayashi T, Nishimori I, Yamashita K, et al. Risk factors and predictors for surgical site infection after hepatic resection [ J ]. J Hosp Infect, 2009,73 ( 1 ) :47-53. DOI: 10. 1016/j. jhin. 2009. 04. 022.
  • 8Sadamori H, Yagi T, Shinoura S, et al. Risk factors for organ/ space surgical site infection after hepateetomy for hepatocellular carcinoma in 359 recent cases [ J ]. J Hepatobiliary Pancreat Sci, 2013,20(2) :186-196. DOI:10. 1007/s00534-011-0503-5.
  • 9Togo S, Matsuo K, Tanaka K, et al. Perioperative infection control and its effectiveness in hepatectomy patients [ J ]. J Gastroenterol Hepatol, 2007,22 ( 11 ) : 1942-1948. DOI: 10. 1111/j. 1440- 1746. 2006. 04761. x.
  • 10Tsujita E, Yamashita Y, Takeishi K, et al. Subcuticular absorba- ble suture with subcutaneous drainage system prevents incisional SSI after hepatectomy for hepatocellular carcinoma [ J ]. World l Sur, 2012,36(7 ) : 1651-1656. DOI: 10. 1007/s00268-012-1524- 1.

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