Risk factors, prevention and treatments for postoperative liver failure in patients with hepatic alveolar echinococcosis
10.3877/cma.j.issn.2095-3232.2018.06.014
- VernacularTitle:肝泡型包虫病术后肝衰竭相关危险因素分析及防治
- Author:
Xiaolei XU
1
;
Zhixin WANG
;
Li REN
;
Lichao HOU
;
Yang Dan Cai Rang
;
Ying ZHOU
;
Haijiu WANG
;
Yong DENG
;
Haining FAN
Author Information
1. 青海大学研究生院
- Keywords:
Echinococcosis,hepatic;
Hepatectomy;
Liver failure;
Risk factors
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2018;7(6):490-494
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors,prevention and treatments for liver failure after hepatectomy for hepatic alveolar echinococcosis.Methods Clinical data of 117 patients with hepatic alveolar echinococcosis admitted to the Affiliated Hospital of Qinghai University from August 2016 to August 2017 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among 117 patients,47 cases were male and 70 female,aged (36±13) years on average.According to whether liver failure occurred after operation,the patients were divided into liver failure group (n=28) and non-liver failure group (n=89).The risk factors of liver failure after hepatectomy were analyzed by univariate and multivariate logistic regression.Results The incidence of postoperative liver failure was 24％ (28/117) and its mortality was 21％ (6/28).21 patients were classified as Child-Pugh grade A,4 grade B and 3 grade C.Multivariate logistic regression analysis showed that Child-Pugh grading,complicated with primary liver diseases,AST,operation time,intraoperative blood loss and intraoperative blood transfusion were the independent factors affecting the occurrence of liver failure (OR=0.089,7.412,1.010,7.926,5.961,11.341;P＜0.05).Conclusions The risk of liver failure after hepatectomy is high in patients with hepatic alveolar echinococcosis.Child-Pugh liver function grading,complicated with primary liver diseases,AST,operation time,intraoperative blood loss and intraoperative blood transfusion are the independent factors for liver failure.Preoperative comprehensive assessment of liver function reserve,shortening the operation time,managing intraoperative bleeding and timely diagnosis and treatment after operation are important measures to prevent the postoperative liver failure.
