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肝癌射频消融后肝内感染的影响因素分析
翟博1,夏念信2,李晓燕1,刘晟1,陈夷1*,吴孟超1
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(1.第二军医大学东方肝胆外科医院超声介入科,上海 200438;2.海军总医院肝胆外科,北京 100037)
摘要:
目的:探讨肝脏肿瘤射频消融后肝内感染的影响因素,以达到有效防治。方法:回顾性总结1999年12月至2007年10月间我院1 567例肝脏肿瘤患者射频消融后肝内感染的临床资料,应用Logistic回归方法对可能的影响因素进行统计分析。结果:1 567例肝脏肿瘤患者2 035次射频消融后28例次发生肝内感染,感染率1.38%。单因素分析提示转移性肝癌、既往腹部手术类型、邻近空腔脏器、肿瘤多发、肿瘤直径>5 cm与射频后肝内感染存在相关性(P<005)。 多因素分析只有肿瘤类型(r=3.647,P=0004)、肿瘤数目(r=1.155,P=0042)、肿瘤部位(r=1.701,P=0019)以及既往腹部手术类型(r=2.213,P=0010)是射频后肝内感染的独立影响因素。结论:转移性肝癌(尤其接受过胃肠或胆肠吻合手术的肝癌)、多发肝癌以及位于空腔脏器附近的肝癌更易发生射频消融后肝内感染。
关键词:  射频消融术  肝肿瘤  肝内感染  影响因素
DOI:10.3724/SP.J.1008.2008.00671
投稿时间:2008-02-12修订日期:2008-05-08
基金项目:
Analysis of factors affecting intrahepatic infection after percutaneous radiofrequency ablation for liver cancers
ZHAI Bo1,XIA Nian-xin2,LI Xiao-yan1,LIU Sheng1,CHEN Yi1*,WU Meng-chao1
(1.Department of Ultrasonic Intervention,Eastern Hepatobiliary Hospital,Second Military Medical University,Shanghai 200438,China;2.Department of Hepatobiliary Surgery,General Hospital of Navy,Beijing 100037)
Abstract:
Objective:To investigate the factors affecting the intrahepatic infection after percutaneous radiofrequency ablation (PRFA) for liver cancers.Methods: The clinical data of 1 567 patients with intrahepatic infection after PRFA for liver cancers (from Dec.1999 to Oct.2007) were retrospectively summarized.Logistic regression method was used to analyze the possible affecting factors. Results: Twenty-eight person-times of intrahepatic infection occurred in 1 635 patients who received a total of 2 035 times of PRFA,with the infecting rate being 1.38%.The intrahepatic infection-related mortality was 0.13%(2/1 567).Univariate analysis indicated that the intrahepatic infection was significantly correlated with metastatic liver cancer,pattern of past abdominal operation,tumor location,tumor size and tumor numbers(P<005).Multivariate analysis showed that the types of liver cancer,tumor number,tumor location and pattern of past abdominal operation were independent risk factors for intrahepatic infection after PRFA for liver cancers(r=3.647,P=0004; r=1.155,P=0042; r=1.701,P=0019; r=2.213,P=0010,respectively).Conclusion: Our findings suggested that patients with metastatic liver cancer(especially for the patients who have received gastroenterostomy or cholangioenterostomy),multi-liver cancer,and cancers locating near the cavity organs are liable to intrahepatic infection after PRFA.
Key words:  percutaneous radiofrequency ablation  liver neoplasms  intrahepatic infection  risk factor