影响肝内胆管癌切除术后患者生存率的危险因素分析及干预对策

目的分析影响肝内胆管癌（ICC）切除术后患者生存率的危险因素，并探讨相应的干预对策。方法回顾自2003年6月份以来人我院治疗的肝内胆管癌患者的资料，分析一般情况（性别、年龄）、个人行为（饮酒、吸炯）患者肝脏相关病史（乙肝、丙肝、肝硬化、胆石症、血吸虫病、肝囊肿以及脂肪性肝炎等与肝内胆管癌切除术后患者生存率的相关性，采用卡方检验、单因素非条件Logistic回归分析和多凼素非条件Logistic回归分析，模型筛选采用Stepwise法。评价影响肝内胆管癌切除术后患者生存率的危险因素。结果显示乙肝肝硬化（OR=1．769，95％CI：1．420—2．115）、酒精性肝硬化（OR=6．447，95％C1：1．826—22．769）、肝内胆管结石（OR=1．863，95％CI：1．709—2．051）、胆总管结石（OR：1．53995％CI：1．042—2．635）、HBsAg（OR=3．640，95％CI：2．169—6．193）等是肝内胆管癌切除术后患者死亡的主要促进因素。结论针对肝内胆管癌切除术后死亡的危险因素，我们提出了对肝内胆管癌患者应注意抗肝硬化、肝胆结石以及乙肝的治疗。

Influence intrahepatic bile duct carcinoma patients after resection of the survival of the risk factor analysis and intervention measures

Objective To analyze intrahepatic cholangiocarcinoma （ICC） after resection in patients with risk factors for survival, and discusses the corresponding countermeasures of intervention. Methods A retrospective review of since 2006 since June, into our treatment of intrahepatic cholangiocarcinoma （ICC） patients with material, such as general condition such as gender, age, individual behavior such as drinking, smoking, patients with hepatitis b and hepatitis c liver related history, liver cirrhosis, cholelithiasis, schistosomiasis, liver cyst, and fatty hepatitis and other related history, intrahepatic cholangiocarcinoma （ICC） patients after resection of the survival situation, analysis the rel- evant risk factors, using the chi-square test, single factor unconditional Logistic regression analysis and multiple fac- tors unconditional Logistic regression analysis, the method of Stepwise model selection. Impact assessment intrahepatic bile duct carcinoma patients after resection of the risk factors for survival. Results Show that hepatitis b cirrhosis （OR = 1.769,95% CI： 1.420 2.115）, alcoholic liver cirrhosis （OR = 6.447,95%CI： 1.826 22.769）, intrahepatic bile duct stones （OR = 1.863, 95% CI： 1.709 2.051）, bravery manager （OR = 1.539 95%CI： 1.042 2.635）, HBsAg （OR = 3.640,95% CI： 2.169 6.193） is intrahepatic cholangiocarcinoma （ICC） patients after resection of the death of the main factors to pro- mote. Conclusion For intrahepatic cholangiocarcinoma （ICC） after resection of the death risk factors, we put forward in- trahepatic cholangiocarcinoma （ICC） should pay attention to resistance to liver cirrhosis, liver and gall stones and the treatment of hepatitis B.