论文部分内容阅读
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 significance of surgical Apgar score in postoperative risk assessment of patients with hilar cholangiocarcinoma (HCCA). Methods Ninety patients with HCCA who underwent radical resection or palliative surgery were analyzed. The correlation between surgical Apgar score and the incidence of postoperative complications and the relationship between postoperative complications and Apgar score were analyzed. Apgar score was divided into low-grade group and high-grade group according to Apgar score. There was no significant difference in Apgar score between the two groups before surgery (P> 0.05); preoperative jaundice level, albumin level, Child’s liver function classification and TMN stage Apgar score was statistically significant (P <0.05). Two groups of patients were successfully completed surgery. Results Complications were found in 60 out of 90 patients, including 1 death. There was significant difference in Apgar score between patients with and without complications (P <0.05). The incidence of postoperative complications was 82.4% , High score group was 57.1%, the difference between the two groups was statistically significant (P <0.05). From a single complication point of view, there was significant difference between liver failure (P <0.05 3), lung infection, the difference was not statistically significant (P> 0.05). There was no significant difference in the incidence of complications between radical resection and palliative surgery (P> 0.05). Complications of two surgical patients Compared with the non-complication group Apgar score, the difference was statistically significant (P all <0.05). Conclusion The Apgar score can predict postoperative complications in HCCA patients, especially liver failure.