摘要
目的探讨外科Apgar评分在肝门部胆管癌(hilar cholangiocarcinoma,HCCA)患者术后风险评估中的临床意义。方法行根治性切除术或姑息性手术的HCCA患者90例,分析外科Apgar评分与患者术后并发症发生率间的相关性及不同术式术后并发症与Apgar评分的关系。根据Apgar评分分为低分组和高分组,手术前两组患者年龄、性别对Apgar评分差异无统计学意义(P>0.05);术前黄疸水平,白蛋白水平,Child肝功能分级和TMN分期对Apgar评分有统计学意义(P<0.05)。两组患者均成功完成手术。结果 90例患者中60例出现并发症,其中死亡1例,并发症与无并发症患者间Apgar评分比较,差异有统计学意义(P<0.05);低分组术后并发症发生率为82.4%,高分组为57.1%,两组比较差异有统计学意义(P<0.05)。从单个并发症来看,肝功能衰竭间比较差异有统计学意义(P<0.053),肺部感染间比较,差异无统计学意义(P>0.05)。不同术式的患者进行术后并发症风险的对比,发现行根治性切除术和姑息性手术间并发症发生率比较,差异无统计学意义(P>0.05);两种术式患者并发症组与无并发症组间Apgar评分比较,差异有统计学意义(P值均<0.05)。结论外科Apgar评分可以预测HCCA患者术后并发症的发生,特别是肝功能衰竭。
Objective To investigate the clinical value of surgical Apgar score in assessment of postoperative risk in patients with Hilar cholangiocarcinomae（HCCA）.Methods We retrospectively analyzed 90 patients with HCCA for radical resection or palliative resection,and analyzed the correlation between the incidence of postoperative complications and the different operative methods for postoperative complication with surgical Apgar score.According to the Apgar score,there were 34 cases of low group,while 56 cases of high group,preoperatively.Apgar score was no statistical significance（P〉0.05）in the age,sex of patients,while Apgar score was statistically significant（P〈0.05）in preoperative jaundice levels,albumin concentrations,child liver function grade and TNM staging.Results Two groups of patients were successfully completed surgery,60 patients in 90 cases with complications,including 1 death.Apgar score comparison between patients with complications and no complications was statistically difference（P〈0.05）.Two groups of postoperative complications,Apgar score was statistically difference（P〈0.05）.As single complications,liver failure was statistically significant（P〈0.05）;lung infection complications was not significant（P〉0.05）.In patients with radical resection and palliative resection,there was no statistically significant difference for postoperative complications（P〉0.05）;while in the two group,Apgar score was statistical difference between the patients with surgical complications and no complications（P〈0.05）.Conclusion Surgical Apgar score line can predict HCCA patients postoperative complications,especially in liver failure.
出处
《临床外科杂志》
2017年第6期426-429,共4页
Journal of Clinical Surgery
