摘要 目的探讨大范围肝切除术后肝癌患者行过渡性重症监护室(intensive care unit,ICU)监护的必要性。方法回顾性分析548例大范围肝切除肝癌患者的临床资料。根据是否进行过渡性ICU监护,分为ICU组(92例)和非ICU组(456例),对两组患者的临床资料、术后并发症及死亡率进行分析。结果两组患者术后大量腹水、肝功能衰竭、胆漏、感染、出血等主要并发症发生率以及死亡率、住院时间对比差异均无统计学意义(P>0.05)。但ICU组患者总住院费用明显高于非ICU组[(72019±24516)元比(67002±21374)元],差异有统计学意义(t=2.004,P=0.046)。多因素分析显示术中出血量和输血量是患者术后行过渡性ICU监护的独立危险因素。结论过渡性的ICU监护不会降低大范围肝切除患者术后并发症发生率和死亡率,反而会增加患者的医疗费用。 Objective To explore the necessity of transitional ICU care for patients with liver cancer after major hepatectomy.Methods The clinical data of 548 liver cancer patients with major hepatectomy were retrospectively analyzed.According to whether by way of transitional ICU care was used or not,patients were divided into ICU group(92 cases)and none-ICU group(456 cases).The clinical data,postoperative complications and mortality were compared.Results There were no difference in the incidence of major complications(ascites,liver failure,bile leakage,infection and bleeding),mortality and length of hospital stay between the two groups(P>0.05).But the total hospitalization costs of patients in the ICU group were significantly higher than those in the non-ICU group[(72019±24516)yuan vs.(67002±21374)yuan,t=2.004,P=0.046].Multivariate analysis showed that intraoperative blood loss and transfusion were independent risk factors for patients undergoing transitional ICU care.Conclusion Transitional ICU care does not reduce the incidence of postoperative complications and mortality for major hepatectomy patients,only increase the hospitalization costs.
机构地区 郑州大学第一附属医院肝胆胰外科
出处 《中华普通外科杂志》 CSCD 北大核心 2021年第4期301-304,共4页 Chinese Journal of General Surgery
分类号 R47 [医药卫生—护理学]
