腹腔镜肝血管瘤切除术患者术后感染相关因素分析

doi:10.3969/j.issn.1672-5069.2017.03.021

摘要/Abstract

摘要： 目的分析影响腹腔镜肝血管瘤切除术患者术后感染的相关因素。方法回顾性分析我院2012年7月~2014年12月收治的286例行腹腔镜肝血管瘤切除术患者,将患者按照不同的临床特征进行分类,采用单因素分析同类特征条件下感染发生率的差异,再将单因素分析结果有意义的因素进行多因素Logistic 回归分析,以得出与腹腔镜肝血管瘤切除术患者术后感染发生的相关危险因素。结果在286例患者中,术后发生感染77例（26.9%）;年龄<60岁与年龄≥60患者术后感染率分别为21.5%和34.2% （P<0.05）,肝切除比例<35%与肝切除比例≥35的患者术后感染率分别为22.1%和37.9% （P<0.05）,肝血管瘤位于肝左叶与位于右叶或左右叶均有的患者术后感染率分别为18.6%、29.1%和39.3%（P<0.05）,病灶直径<10 cm与病灶直径>10 cm的患者术后感染率分别为21.9%和43.3%（P<0.05）,无慢性病史与有慢性病史的患者术后感染率分别为23.6%和39.3% （P<0.05）,术前ALT水平<40U/L与术前ALT水平≥40U/L的患者术后感染率分别为24.4%和33.3% （P<0.05）,出血量<300 ml与出血量≥300 ml的患者术后感染率分别为22.1%和41.1% （P<0.05）,无输血与输血的患者术后感染率分别为24.4%和38.5%（P<0.05）,术后无并发症与术后有并发症的患者术后感染率分别为22.4%和55.0% （P<0.05）;将单因素处理有意义的因素进行多因素Logistic回归分析,结果显示肝切除比例、病灶直径、慢性病史、出血量、输血和术后并发症为影响腹腔镜肝血管瘤切除术患者术后发生感染的主要危险因素（P<0.05）。结论腹腔镜肝血管瘤切除术患者可能发生术后感染,需要对具有危险因素的患者特别予以防治。

关键词: 肝血管瘤, 血管瘤切除术, 腹腔镜, 感染, 危险因素

Abstract: Objective To analyse the risk factors of postoperative infection in patients underwent laparoscopic resection of hepatic hemangioma. Methods The clinical data of 286 patients underwent laparoscopic resection of hepatic hemangioma between July 2012 and December 2014 was retrospectively analyzed. The patients were divided into different groups according to different clinical features. The prevalence of postoperative infection was analyzed by univariate analysis,and the independent risk factors were confirmed by Logistic regression analysis. Results The postoperative infection occurred in 77 cases（26.92%） among 286 patients in our series; the percentage of postoperative infection was 21.5% and 34.2%,respectively,in patients younger than and greater than 60-year-old（P<0.05）,and they were 22.1% and 37.9% in patients having their liver resected < 35% and ≥ 35%（P<0.05）,18.6%,29.1% and 39.3% in patients with hemangioma on the left,right and both left and right lobe （P<0.05）,21.9% and 43.3% in patients with lesion size less than 10 cm and with greater than 10 cm （P<0.05）,23.6% and 39.3% in patients without and with history of chronic diseases（P<0.05）,24.4% and 33.3% in patients with normal and with elevated serum ALT levels（P<0.05）,22.1% and 41.1% in patients with bleeding amount <300 ml and in patients with bleeding amount ≥300 ml （P<0.05）,24.4% and 38.5% in patients without and with blood transfusion（P<0.05）,and 22.4% and 55.0% in patients without and with postoperative complications （P<0.05）;Logistic regression analysis revealed that liver resection ratio,lesion size,chronic diseases history,amount of bleeding,blood transfusion and postoperative complications were related to the prevalence of postoperative infection in patients underwent laparoscopic resection of hepatic hemangioma（P<0.05）. Conclusion The postoperative infections might occur in patients underwent laparoscopic resection of hepatic hemangioma,which needs special concern in patients with risk factors.

Key words: Hepatic hemangioma, Laparoscopy resection, Postoperative infection, Risk factors

闫军, 李亮. 腹腔镜肝血管瘤切除术患者术后感染相关因素分析[J]. 实用肝脏病杂志, 2017, 20(3): 341-344.

Yan Jun, Li Liang. Risk factors of postoperative infection in patients underwent laparoscopic resection of hepatic hemangioma[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(3): 341-344.

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