肝癌微波治疗术对患者肾功能影响因素的分析

目的 探讨肝癌微波治疗术期出现肾功能不全的影响因素。方法 回顾性分析在2012年6月-2014年12月期间,哈尔滨医科大学附属肿瘤医院肝胆外科治疗的80例行肝癌微波治疗术患者的临床资料;根据围术期有无出现肾功能不全,将患者分为肾功能不全组(n=44)与肾功能正常组(n=36);对比分析两组患者术前ALT、TBIL、BUN、术中低血压、术中尿量、年龄、微波消融时间、肿瘤与肝大血管距离、微波消融范围、性别等危险因素的差异。结果 肾功能不全组与肾功能正常组患者之间的术中尿量无统计学差异(P＞0.05);而肾功能不全组与肾功能正常组患者之间的术前ALT、TBIL、BUN、术中低血压、年龄、微波消融时间、肿瘤与肝大血管距离、微波消融范围和性别具有统计学差异(P＜0.05)。BUN与术前ALT、术前TBIL、术前BUN、术中低血压、年龄、肿瘤与肝大血管距离、微波消融时间、微波消融范围、性别影响因素均呈正相关(r=0.63、0.60、0.58、0.49、0.45、0.40、0.35、0.46、0.52,P＜0.05)。BUN的影响因素强弱依次为肿瘤与肝大血管距离、微波消融范围、术中低血压、术前ALT、性别、术前TBIL、微波消融时间、年龄和术前BUN(标准化回归系数分别为-0.52、0.42、0.37、0.31、0.29、0.25、0.20、0.18和0.16,P＜0.05)。结论 肝癌微波治疗术患者出现肾功能不全的危险因素呈多方面,与术前ALT、术前TBIL、术前BUN、术中低血压、年龄、肿瘤与肝大血管距离、微波消融时间、微波消融范围、性别密切相关。

Analysis on the influence factors of renal insufficiency in patients with hepatocellular carcinoma during microwave therapy

Objective To explore the influence of renal insufficiency with microwave therapy in the treatment of liver cancer.Methods A retrospective clinical analysis with 80 patients who underwent microwave therapy of liver cancer,was performed from June 2012 to March 2014 in the department of hepatobiliary and pancreatic surgery,the Affiliated Tumor Hospital of Harbin Medical University.According to perioperative presence of renal insufficiency,we divided the patients into renal dysfunction group(A)(n=44)and normal renal function group(B)(n=36);Preoperative ALT,TBIL,BUN,intraoperative hypotension,intraoperative urinary volume,age,the distance between the tumor and the main vessels in the liver,postoperative microwave ablation time the differences of the risk factors,such as microwave ablation range and sex of the two groups were compared during microwave therapy.Results There was no statistical significant difference between the two groups on intraoperative urinary volume(P＞0.05);The preoperative ALT,TBIL,BUN,intraoperative hypotension,age,microwave ablation time,the distance between the tumor and the main vessels in the liver,scular microwave ablation range,sex of two groups showed statistical differences(P＜0.05).BUN with preoperative ALT,TBIL,preoperative BUN,intraoperative hypotension,age,the distance between the tumor and the main vessels in the liver,time of microwave ablation,microwave ablation range,sex influence factors were positively correlated(r=0.63,0.60,0.58,0.49,0.45,0.40,0.35,0.46,0.52,P＜0.05).Strength and influencing factors of BUN are the distance between the tumor and the main vessels in the liver,microwave ablation range,intraoperative hypotension,preoperative ALT,sex,preoperative TBIL,microwave ablation time,age,preoperative BUN(β=0.52,0.42,0.37,0.31,0.29,0.25,0.20,0.18,0.16,P＜0.05).Conclusion Microwave therapy leads to renal insufficiency in the treatment of liver cancer performs many aspects,including preoperative ALT,TBIL,preoperative preoperative BUN,intraoperative hypotension,age,the distance between the tumor and the main vessels in the liver,time of microwave ablation,microwave ablation range,sex,which is closely related to the factors affecting the risk of kidney.