【摘要】 目的探讨原发性肝癌患者药物洗脱微球经导管化疗栓塞(DEB-TACE)术后继发感染的危险因素。方法回顾性分析2016年1月至2018年3月南方医科大学南方医院168例行DEB-TACE治疗肝癌患者的病例资料。根据DEB-TACE术后是否继发感染分为感染组与未感染组,分析肝癌患者DEB-TACE术后继发感染的潜在危险因素。结果 168例次DEB-TACE手术术后继发感染20例,感染率为11.9%。感染以腹腔感染和肺部感染为主。单因素分析显示,肝外转移、胸腔积液、腹水、加用明胶海绵/聚乙烯醇(PVA)颗粒是DEB-TACE术后继发感染的潜在风险因素(P <0.05)。多因素分析显示,肝外转移、腹水、加用明胶海绵/PVA颗粒是原发性肝癌患者DEB-TACE术后继发感染的独立危险因素。结论 DEB-TACE术后感染的发生率较高,肝外转移、腹水、加用明胶海绵/PVA颗粒是原发性肝癌患者DEB-TACE术后继发感染的独立危险因素。为避免感染的发生,医生应在术前充分考虑这些因素并给予相应的预防措施。更多还原

【Abstract】 Objective To identity the risk factors of secondary infection after transcatheter arterial chemoembolization with drugeluting beads in patients with primary liver cancer. Methods The clinical data of 168 patients undergoing DEB-TACE for liver cancer in Southern Medical University from January 2016 to March 2018 were analyzed. Patients were divided into infection group and noninfection group according to the secondary infection after DEB-TACE. The possible risk factors that might induce secondary infection after DEB-TACE were analyzed by using chi-square test or Mann-whitney U test. Variables with P < 0. 05 in the univariate analysis were included in a multivariate model to identify independent risk factors of secondary infection after transarterial chemoembolization with drug-eluting beads for primary liver cancer. Results There were 20 secondary infections after 168 DEB-TACE operations,the infection rate was 11. 9%. The abdominal cavity and lungs are the main sites of infection. The univariate analysis showed distant metastasis,ascites,hepatic hydrothorax,PVA/genlatin sponge particles were potential risk factors for secondary infection after DEB-TACE( P <0. 05). In the multivariate logistic regression analysis,distant metastasis,ascites and PVA/genlatin sponge particles are significantly correlated with the occurrence of secondary infection after TACE. Conclusion Distant metastasis,ascites and PVA/genlatin sponge particles are significantly correlated with the occurrence of secondary infection after DEB-TACE. In order to avoid postoperative infection,doctors should consider these factors and give appropriate preventive measures before surgery.更多还原