CAJ | 학술논문

目的探讨肝脏脂肪变性对肝脏切除手术安全性及预后的影响。方法选取2012年1月—2014年12月在我院接受肝切除术治疗的肝癌患者172例，根据 HE 染色结果，172例患者中无脂肪变性106例（对照组），轻度脂肪变性42例（轻度组），中重度脂肪24例（中重度组），比较各组患者基本资料（性别、年龄等）、手术情况、生化指标、术后并发症、住院时间等。结果三组患者体重指数（BMI）差异有统计学意义（P ＜0.05），中重度组BMI 最高，为（26.94±3.14） kg／m2；中重度组患者手术时间、术中出血量、输注红细胞和肝门阻断时间分别为（182.39±42.17）min、（553.07±50.22）mL、（1.18±0.34）U 和（20.15±6.07）min，均高于其他两组（P ＜0.05）；中重度组患者重度并发症发生率为45.83％，高于对照组和轻度组的9.43％和9.52％（P ＜0.05）；中重度组住院时间和 ICU 时间分别为（23.06±7.30）d 和（3.71±1.03）d，高于其他两组（P ＜0.05）。结论轻度肝脏脂肪变性对手术基本无影响，而中重度脂肪变性会增加手术时间和出血、重度并发症发生较多，不利于手术的安全性以及预后。
목적탐토간장지방변성대간장절제수술안전성급예후적영향。방법선취2012년1월—2014년12월재아원접수간절제술치료적간암환자172례，근거 HE 염색결과，172례환자중무지방변성106례（대조조），경도지방변성42례（경도조），중중도지방24례（중중도조），비교각조환자기본자료（성별、년령등）、수술정황、생화지표、술후병발증、주원시간등。결과삼조환자체중지수（BMI）차이유통계학의의（P ＜0.05），중중도조BMI 최고，위（26.94±3.14） kg／m2；중중도조환자수술시간、술중출혈량、수주홍세포화간문조단시간분별위（182.39±42.17）min、（553.07±50.22）mL、（1.18±0.34）U 화（20.15±6.07）min，균고우기타량조（P ＜0.05）；중중도조환자중도병발증발생솔위45.83％，고우대조조화경도조적9.43％화9.52％（P ＜0.05）；중중도조주원시간화 ICU 시간분별위（23.06±7.30）d 화（3.71±1.03）d，고우기타량조（P ＜0.05）。결론경도간장지방변성대수술기본무영향，이중중도지방변성회증가수술시간화출혈、중도병발증발생교다，불리우수술적안전성이급예후。
Objective To explore the effect of liver steatosis on liver resection safety and the prognosis. Methods Selected from January 2012 to December 2014 in our hospital liver resection of 172 cases of liver cancer patients,according to the results of HE staining,172 patients without fatty degeneration in 106 cases (control group),42 cases of mild steatosis (mild steatosis group),24 cases of severe fatty (moderate and severe steatosis group),observed each group patients the clinical char-acteristics,surgery situation,biochemical index,postoperative complications,hospitalization time,etc. Results Body mass index (BMI)of patients in the three groups difference was statistically significant (P <0.05),moderate and severe steatosis group had the highest BMI (26.94 ±3.14)kg/m2;in moderate and severe steatosis group,surgery time,intraoperative bleed-ing volume,infusion of red blood cells and hepatic portal occlusion time were (182.39 ±42.17)min,(553.07 ±50.22)ml, (1.18 ±0.34)U and (20.15 ±6.07)min.They were significantly higher than that of the control group and mild steatosis group (P <0.05);moderate and severe steatosis patients with severe complication rate was 45.83%,significantly higher than that in the control group and the mild steatosis 9.43% and 9.52%.The difference was statistically significant (P <0.05);In moderate and severe steatosis group,hospitalization time and ICU were (23.06 ±7.30)d and (3.71 ±1.03)d,significantly higher than that in the control group and the mild steatosis group (P <0.05). Conclusion Mild liver steatosis have no effect on the sur-gery,severe liver steatosis may increase the surgery time and bleeding,severe complications occurred more,is not conducive to the safety of the surgery and prognosis.