论文部分内容阅读
目的探讨影响肝内胆管癌术后患者生存的危险因素。方法回顾性分析本院2009年3月至2014年3月收治的行根治性切除术的肝内胆管癌患者的临床资料,选择32种临床和实验室诊断检测相关指标,分析影响肝内胆管癌根治性切除患者术后生存危险因素,采用单因素、多因素Cox模型分析影响肝内胆管癌患者术后生存的危险因素。结果最终入选患者189例,多因素分析表明,肿瘤数目、肿瘤大小、淋巴结转移情况、术前CA19-9水平、术前γ-谷氨酰转移酶、术后第1天血总胆红素及术后第5天血丙氨酸转氨酶是肝内胆管癌根治性切除患者术后生存的独立危险因素(P<0.05)。结论术后第1天总胆红素及术后第5天丙氨酸转氨酶水平对肝内胆管癌根治性切除患者预后有指示作用;术前、术后积极保肝治疗,改善营养状况,术中尽量减少对肝脏的创伤,均有利于改善预后。
Objective To explore the risk factors affecting the survival of patients with intrahepatic cholangiocarcinoma after operation. Methods The clinical data of patients with intrahepatic cholangiocarcinoma who underwent radical resection from March 2009 to March 2014 in our hospital were retrospectively analyzed. 32 clinical and laboratory diagnostic tests were selected to analyze the influencing factors of intrahepatic cholangiocarcinoma Radical resection of patients with postoperative survival risk factors, single factor, multivariate Cox model analysis of risk factors for postoperative survival in patients with intrahepatic cholangiocarcinoma. Results A total of 189 patients were enrolled in the study. Multivariate analysis showed that the number of tumors, tumor size, lymph node metastasis, preoperative CA19-9 levels, preoperative γ-glutamyl transferase, total bilirubin On the fifth postoperative day, ALT was an independent risk factor for postoperative survival in patients with intrahepatic cholangiocarcinoma (P <0.05). Conclusions The total bilirubin on postoperative day 1 and the level of alanine aminotransferase on the 5th postoperative day are indicative of the prognosis of patients with radical resection of intrahepatic cholangiocarcinoma. Preoperative and postoperative positive hepatobiliary therapy can improve the nutritional status To minimize the trauma to the liver, are conducive to improving the prognosis.