原发性肝癌切除术后高胆红素血症临床分析

目的探究分析原发性肝癌切除术之后导致高胆红素血症临床因素。方法选自我院2011—2013年原发性肝癌切除术患者共50例,以手术之后血清总胆红素水平划分组别,为高胆红素组(14例)和胆红素正常组(36例)。对患者术后胆红素变化特点进行观察且分析导致患者术后出现高胆红素血症的临床因素。结果胆红素正常组术后的血清总胆红素4d之后达到峰值(21.5μmol/L),术后14d恢复正常水平;高胆红素血症组患者在术后7d血清总胆红素达到峰值(36.1μmol/L),术后14d高于正常数值2倍左右。对临床单因素进行Logistic进行分析,认为术后出现高胆红素血症主要和术中肝血流阻断方式、输血情况、出血方式还有肝功能Child有关系;进行多因素Logistic进行分析则表明原发性肝癌切除术之后高胆红素血症独立预测指标为术前胆红素水平。结论进行动态监测血清胆红素水平,对于原发性肝癌切除术后来说是非常重要的程序。

Clinical analysis of hyperbilirubinemia after resection of hepatocellular carcinoma

Objective To explore the analysis after resection of hepatocellular carcinoma and clinical factors of hyperbilirubinemia. Methods Selected in our hospital from 2011 -2013 years after liver resection for hepatocellular carcinoma in patients with a total of 50 cases with operation, then serum total bilirubin level division group, high bilirubin group （14 cases） and normal bilirubin group （36 cases）. Clinical factors of postoperative hyperbilirubinemia and bilirubin were observe and analyze changes result in patients after. Results The serum total bilirubin in normal group after 4 days after peak （21.5 μ mol/L）, returned to normal levels after 14 days; hyperbilirubinemia group 7 days after surgery in patients with serum total bilirubin peak （36.1μ mol/L）, after 14 days at 2 times the normal amount of left and right. The clinical analysis of single factor Logistic, think of postoperative hyperbilirubinemia and intraoperative hepatic blood occlusion methods, blood transfusion, blood and liver function Child way relationship; multivariate Logistic analysis showed that after resection of hepatocellular carcinoma with independent predictors for preoperative bilirubin level. Conclusion The serum bilirubin level dynamic monitoring, for after resection of hepatocellular carcinoma is a very important procedur