中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2009年
21期
1616-1619
,共4页
李相成%姚爱华%成峰%张传永%李国强%陆森%王科%钱晓峰%浦立勇%王平%许永华%王学浩
李相成%姚愛華%成峰%張傳永%李國彊%陸森%王科%錢曉峰%浦立勇%王平%許永華%王學浩
리상성%요애화%성봉%장전영%리국강%륙삼%왕과%전효봉%포립용%왕평%허영화%왕학호
肝切除术%手术后并发症%因素分析%统计学
肝切除術%手術後併髮癥%因素分析%統計學
간절제술%수술후병발증%인소분석%통계학
Hepatectomy%Postoperative complications%Factors analysis,statistical
目的 分析微创化技术对肝切除患者围手术期的影响.方法 收集南京医科大学第一附属医院肝移植中心单个手术小组于2003年8月至2008年8月间所开展的338例肝切除手术患者的临床资料,分析应用微创化技术对患者术中出血量、并发症发生率、围手术期病死率的影响.结果 338例肝切除术的病例中,255例(75.4%)患者进行解剖性肝叶或肝段的精准肝切除术.手术平均时间150 min(45～650 min);术中出血量300 ml(100～4600 m1),211例(62.4%)术中未输血.围手术期总并发症发生率为18.1%,病死率为0.6%.多因素Logistic回归分析表明,围手术期输血和低血小板血症足肝切除围手术期并发症发生的独立预后因子.结论 体现微创化技术的精准肝切除术可使患者获得较好的临床结果 ,并发症发生率和病死率处于较低的水平.减少术中出血是获得围手术期良好临床结果 的重要因素.
目的 分析微創化技術對肝切除患者圍手術期的影響.方法 收集南京醫科大學第一附屬醫院肝移植中心單箇手術小組于2003年8月至2008年8月間所開展的338例肝切除手術患者的臨床資料,分析應用微創化技術對患者術中齣血量、併髮癥髮生率、圍手術期病死率的影響.結果 338例肝切除術的病例中,255例(75.4%)患者進行解剖性肝葉或肝段的精準肝切除術.手術平均時間150 min(45～650 min);術中齣血量300 ml(100～4600 m1),211例(62.4%)術中未輸血.圍手術期總併髮癥髮生率為18.1%,病死率為0.6%.多因素Logistic迴歸分析錶明,圍手術期輸血和低血小闆血癥足肝切除圍手術期併髮癥髮生的獨立預後因子.結論 體現微創化技術的精準肝切除術可使患者穫得較好的臨床結果 ,併髮癥髮生率和病死率處于較低的水平.減少術中齣血是穫得圍手術期良好臨床結果 的重要因素.
목적 분석미창화기술대간절제환자위수술기적영향.방법 수집남경의과대학제일부속의원간이식중심단개수술소조우2003년8월지2008년8월간소개전적338례간절제수술환자적림상자료,분석응용미창화기술대환자술중출혈량、병발증발생솔、위수술기병사솔적영향.결과 338례간절제술적병례중,255례(75.4%)환자진행해부성간협혹간단적정준간절제술.수술평균시간150 min(45～650 min);술중출혈량300 ml(100～4600 m1),211례(62.4%)술중미수혈.위수술기총병발증발생솔위18.1%,병사솔위0.6%.다인소Logistic회귀분석표명,위수술기수혈화저혈소판혈증족간절제위수술기병발증발생적독립예후인자.결론 체현미창화기술적정준간절제술가사환자획득교호적림상결과 ,병발증발생솔화병사솔처우교저적수평.감소술중출혈시획득위수술기량호림상결과 적중요인소.
Objective To evaluate the perioperative clinical outcome and predictive factors for perioperative complication morbidity and mortality.Methods From August 2003 to August 2008,the data of 338 cases of hepatectomy performed in the liver transplant center of the First Affiliated Hospital of Nanjing Medical University Was collected in a prospective manner.The patients' perioperative clinical risk factors and results were analyzed.Results In the 338 hepatectomy cases,255 patients (75.4%) underwent precise anatomical hepatectomy.The overall perioperative complication morbidity Was 18.1%.while the perioperative mortality was 0.6%.In a total of 211(62.4%)cases,the operation was carried out without blood transfusion.Univariate analysis revealed that cirrhotic liver,thrombocytopenia,blood loss in operation>1000 ml,blood transfusion in operation and several other factors were closely related with the incidence rate of complication.Multivariate logistic regression analysis indicated that thrombocytopenia and perioperative blood transfusion were important independently predictive factors for the occurrence of perioperative complications in hepatectomy.Conclusions Precise hepatectomy enables patients to obtain better clinical outcome with low complication morbidity and perioperative mortality.Reducing hemorrhage is an important factor that lead to good clinical results.
