肝部分切除治疗肝内胆管结石患者术后并发症及影响因素分析

目的:分析肝部分切除术治疗肝内胆管结石患者术后并发症及影响因素。方法:选取我院收治的肝内胆管结石患者117例,均采取肝部分切除术治疗,对其临床资料进行回顾性分析,研究术后并发症的发生情况,并对影响因素进行分析。结果:本组117例患者,并发症发生率35.04%,其中肝功能衰竭1例,胆道出血2例,消化道出血6例,腹腔感染6例,胆瘘6例,胸腔积液8例,切口感染12例。并发症组患者术前白蛋白、手术时间、既往胆道手术史水平与非并发症组比较,差异均有统计学意义(P0.05)。肝部分切除术后的并发症多因素Logistic回归分析结果显示,手术时间、既往胆道手术史均是术后并发症独立风险因素。结论:肝部分切除术治疗肝内胆管结石患者术后并发症发生率较高,以切口感染和胸腔积液为最,患者的既往手术史以及手术时间均是影响并发症发生的重要危险因素,做好针对性预防可预防并发症的发生。

Analysis of Postoperative Complications and Influence Factors of Patients with Intrahepatic Biliary Calculi after Partial Hepatectomy

ABSTRACT Objective: To analyze the postoperative complications and influence factors of patients with intrahepatic biliary calculi after partial hepatectomy. Methods: 117 cases of patients with intrahepatic biliary calculi in our hospital were selected and all went through partial hepatectomy. The clinical data were retrospectively analyzed, and the occurrence of postoperative complications studied, and the influence factors analyzed. Results: Among the 117 patients, the incidence of complications was 35.04%, including 1 cases of liver failure, 2 cases of biliary tract bleeding, 6 cases of gastrointestinal bleeding, 6 cases of abdominal infection, 6 cases of biliary fistula, 8 cases of pleural effusion, 12 cases of incision infection. Significant differences existed among preoperative albumin level, operation time and biliary tract surgery history between the complication group and non-complication group (P<0.05). The multivariate Logistic regression analysis of postoperative complications of partial hepatectomy showed that the operation time and the history of biliary tract surgery were independent risk factors for complications. Conclusion: Partial hepatectomy for patients with intrahepatic biliary calculi has a high incidence of postoperative complications, with incision infection and pleural effusion are the most common ones. The history of previous surgery and operation time are important risk factors of complications. Targeted precautions can prevent the occurrence of complications.