70例肝硬化门脉高压症患者术前评估及术后生存率分析

目的研究门脉高压症患者术前肝功能及病毒复制状况对其预后的影响。方法按改良Child肝功能分级法对70例肝硬化门脉高压症接受手术治疗者作术前肝功能评估，并对术后并发症、肝炎再活动、1年和5年生存率进行分析。结果肝功能分级与手术时机的选择是影响预后的独立因素，5年生存率依次为A级〉B级〉C级；活动性肝硬化术后并发症发生率显著高于静止期肝硬化（P〈0．01）；急症手术者术后死亡率显著高于择期手术者（P〈0．01）；术前病毒复制指标阳性者术后半年内肝炎活动率显著高于病毒复制指标阴性者（P〈0．01）。结论肝硬化门脉高压症患者术后5年生存率与术前肝功能贮备密切相关，急症手术的风险较之择期手术的风险为大。

The influence of preoperative liver function and HBV replication on the prognosis of posthepatitic cirrhosis with portal hypertension

Objective To study the influence of preoperative liver function and virus replication condition on postoperative prognosis.Methods According to the Child's classification,70 cases of posthepatitic cirrhosis with portal hypertension were divided into grade A,B and C.The liver function,complication,hepatitis activity,survival rate after 1 year and 5 years were observed.Results The grade of liver function and the operation opportunity were independent factors in prognosis after operation.The incidence of complication in active cirrhosis was higher than that in still cirrhosis(42% Vs 11.8%,P<(0.01).)The mortality in emergency operation was higher than that in selective operation(4/7 Vs 3/55 P<0.01).The hepatitis activity in cases with virus replication was higher than that without virus replication(57.6% Vs 12% P<0.01).Conclusions The five years survival rate was related to reserve of liver function and virus replication.