腹壁修复的肝硬化患者的外科风险和风险因素:人口层面的分析
Sean Bennett1, Jennifer A Flemming2, Maya Djerboua3
1Division of General Surgery, Department of Surgery, Queen's University, Kingston, ON, Canada.
Surgery
|June 13, 2025
概括
肝硬化患者的紧急修复与选择性手术相比,死亡风险增加了8倍. 对大多数肝硬化患者来说,建议选择性修复,考虑个体风险因素,如年龄和疾病严重程度.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 腹壁在肝硬化患者中很常见,具有显著的外科手术风险.
- 了解这一群体修复的结果和风险因素至关重要.
研究的目的:
- 描述外科手术后的结果,并识别发生修复的肝硬化患者的危险因素.
- 为了比较紧急和可选修复手术之间的结果.
主要方法:
- 在安大略省 (2009-2018) 进行修复的成年肝硬化患者的回顾性人口研究.
- 分析90天死亡率,肝脏衰竭事件,并发症和输血.
- 用于估计死亡率和肝脏衰竭的调整相对风险的普森回归模型.
主要成果:
- 确定了6040名患者;79%接受了选择性修复. 整体90天死亡率为4% (1.1%的选择性 vs 15.5%的紧急情况).
- 死亡风险因素包括年龄,肝硬化病因 (HCV,酒精),并发症,新出现的手术和MELD-Na得分.
- 手术后肝脏衰竭的风险增加了先前衰竭史和MELD-Na得分. 在紧急维修中,并发症的发生率更高 (23.8%对比9.5%).
结论:
- 肝硬化患者的紧急修复与明显更高的并发症和8倍增加的死亡风险有关.
- 对大多数肝硬化患者来说,选择性修复是可以支持的,要仔细考虑年龄,并发症和肝硬化严重程度.
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