ASA 评分在肝癌患者外科治疗风险评估中的作用

目的：探讨ASA评分对肝癌患者外科治疗风险评估的价值。 方法：回顾2006年1月—2010年12月419例原发性肝癌肝切除患者围手术期临床资料，分析患者ASA评分与临床因素的关系，并对可能的相关因素作单因素筛选后行多因素回归分析，分析肝癌术后并发症及术中输血有关的影响因素。 结果：统计分析显示，肝癌患者术前并发症及术前血红蛋白影响ASA评分；随着ASA评分上升，患者术中失血量、输血量、术后并发症及住院天数明显高增加（均P<0.05）。多因素回归分析结果显示，ASA评分、失血量、肝硬化、年龄、丙氨酸转氨酶（ALT）水平是术后并发症发生的独立影响因素（均P<0.05）；ASA评分、手术时间、肿瘤直径是术中输血的独立影响因素（均P<0.05）。 结论：ASA评分是肝癌患者围手术期风险较好的早期预测指标。

Use of ASA score in surgical risk estimation for liver cancer patients

Objective: To assess the value of ASA score in risk estimation for liver cancer patients undergoing surgical treatment. Methods: The perioperative clinical data of 419 patients undergoing hepatectomy for primary liver cancer from January 2006 to December 2010 were reviewed. The relationship between ASA score and clinical factors of the patients was analyzed, and the factors associated with postoperative complications and intraoperative blood transfusion were determined by multivariate regression analysis after univariate analysis screen for the possible related factors. Results: Statistical analysis showed that ASA score was affected by preoperative complications and hemoglobin content in liver cancer patients, and the intraoperative blood loss, blood transfusion volume, postoperative complications, and length of postoperative hospital stay was increased with ASA score increase (all P<0.05). Multivariate regression analysis identified that ASA score, intraoperative blood loss, liver cirrhosis, age, and alanine aminotransferase (ALT) level were independent factors for the occurrence of postoperative complications (all P<0.05), and ASA score, operative time, and tumor diameter were independent factors for intraoperative blood transfusion (all P<0.05). Conclusion: ASA score is a better index for early estimation of the perioperative risk of liver cancer patients undergoing hepatectomy.