CAJ | 학술논문

目的研究肝癌解剖性肝切除术后并发症独立危险因素,评价联合应用剩余肝体积(future liver volume rate,FLVR)的Child-Pugh/FLVR评分指标对预测术后并发症的价值. 方法回顾性分析247例肝癌肝切除患者临床资料、术后并发症,对术后并发症进行单因素分析,对有统计学差异的单因素进行有序logistic回归分析,使用受试者工作特征(ROC)曲线评估Child-Pugh/FLVR评分预测性能和最佳诊断界值. 结果天冬氨酸转氨酶(aspartate aminotransferase,AST)(P=0.026,OR=1.009)、血小板计数(P =0.007,OR=0.991)、国际标准化比值(international normalized ratio,INR)(P=0.013,OR=45.409)、术中红细胞数输入(P=0.006,OR=1.191)和Child-Pugh分级/FLVR(P=0.007,OR=1.174)是术后总体并发症发生的独立危险因素;ROC曲线分析Child-Pugh/FLVR评分(Child-Pugh/FLVR)临界值是7.68,Child-Pugh评分、FLVR和Child-Pugh/FLVR评分曲线下面积分别为0.620、0.648和0.712.结论 Child-Pugh/FLVR评分是肝切除术后并发症的独立危险因素;Child-Pugh/FLVR对于术后并发症具有良好的预测性.
목적 연구간암해부성간절제술후병발증독립위험인소,평개연합응용잉여간체적(future liver volume rate,FLVR)적Child-Pugh/FLVR평분지표대예측술후병발증적개치. 방법 회고성분석247례간암간절제환자림상자료、술후병발증,대술후병발증진행단인소분석,대유통계학차이적단인소진행유서logistic회귀분석,사용수시자공작특정(ROC)곡선평고Child-Pugh/FLVR평분예측성능화최가진단계치. 결과 천동안산전안매(aspartate aminotransferase,AST)(P=0.026,OR=1.009)、혈소판계수(P =0.007,OR=0.991)、국제표준화비치(international normalized ratio,INR)(P=0.013,OR=45.409)、술중홍세포수수입(P=0.006,OR=1.191)화Child-Pugh분급/FLVR(P=0.007,OR=1.174)시술후총체병발증발생적독립위험인소;ROC곡선분석Child-Pugh/FLVR평분(Child-Pugh/FLVR)림계치시7.68,Child-Pugh평분、FLVR화Child-Pugh/FLVR평분곡선하면적분별위0.620、0.648화0.712.결론 Child-Pugh/FLVR평분시간절제술후병발증적독립위험인소;Child-Pugh/FLVR대우술후병발증구유량호적예측성.
Objective To investigate the risk factors that are related to the postoperative complications after anatomic hepatectomy for primary liver cancer and evaluate Child-Pugh/FLVR in predicting postoperative complications after anatomic hepatectomy.Methods The preoperative clinical data of 247 patients with hepatocellular carcinoma who were treated with anatomic hepatectomy were retrospectively analyzed.Through ordinal logistic regression method together with ROC analysis the predicting value and the optimal diagnostic boundary value of the factors were assessed.Results Ordinal logistic regression analysis indicated that AST(P =0.026,OR =1.009),PLT(P =0.007,OR =0.991),INR(P =0.013,OR =45.409),Red blood cell transfusion (P =0.006,OR =1.191) and Child-Pugh/FLVR (P =0.007,OR =1.174) were the factors that affected the complication after anatomic hepatectomy.ROC analysis demonstrated that the border value of Child-Pugh/FLVR was 7.68,which was a helpful predictor for postoperative complication.The areas under the ROC curves of the Child-Pugh score,FLVR and the ChildPugh/FLVR score were 0.620,0.648 and 0.712.Conclusions Child-Pugh/FLVR carries higher sensitivity and specificity in predicting postoperative hyperthermia and,therefore,can be used as a predictor for postoperative complications.