Analysis Of Relative Affecting Factors Of Pulmonary Infection After Hepatectomy For Liver Cancer

Objective: The purpose of study is analyzed the clinical index of the patients with hepatectomy for liver cancer,to find out the independent risk factors of pulmonary infection after liver resection for liver cancer.Conducted a thorough discussion of independent risk factors.The aim is to provide a basis for the development of targeted preventive measures to reduce the incidence of pulmonary infection after liver resection for liver cancer.Methods: Retrospective analysis of the clinical data of 299 patients with hepatocellular carcinoma from September 2007 to September 2015 in the Second Affiliated Hospital of Dalian Medical University,according to the inclusion and exclusion criteria,a total of209 cases were included in the final analysis,according to whether the patient had pulmonary infection after operation,209 cases were divided into the infection group(56cases)and the control group(153 cases).The patient's preoperative,intraoperative and postoperative clinical indicators of pulmonary infection after liver resection for liver cancer were analyzed statistically.Data analysis application SPSS17.0 software,when evaluating these related factors,two sets of measurement data(in line with the normal distribution)of the comparison with the t test,by the mean and standard deviation(-?±s)said,count data were compared with the ?2test.Then all the statistical variables were included in single factor Logistic regression analysis and univariate correlation analysis.The correlation factors of pulmonary infection after liver resection were obtained.The relevant influencing factors with statistical significance were included in the multivariate Logistic regression analysis,to determine the risk factors of pulmonary infection after liver resection for liver cancer,P < 0.05 was considered the difference was statistically significant.Results:1.The result of pulmonary infection in patients with liver cancer after hepatectomy.The incidence of pulmonary infection after liver resection for liver cancer was 26.79%.2.The results of the comparison between the infection group and the control group of patients?clinical index.The general situation,preoperative,intraoperative and postoperative clinical indexes of the infection group and the control group were statistically analyzed.The measurement data were analyzed by t test,count data were analyzed by ?2 test.The results showed that after age(t=2.55,P = 0.01),abdominal cavity drainage tube indwelling time(t=3.30,P= 0.00),total bilirubin in fifth days after operation(t=2.25,P = 0.03),operation distance discharge time(t=4.66,P = 0.00),postoperative pleural effusion(?2 =98.23,P = 0.00),postoperative atelectasis(?2=18.92,P = 0.00)between the difference is significant(P <0.05),The other clinical parameters were not statistically significant(P>0.05).3.Univariate Logistic regression analysis and bivariate correlation analysis results of various clinical parameters.The statistics of the two groups of patients with various clinical parameters were included in the univariate Logistic regression analysis: Patient age(P1 = 0.032,?=0.034),operation distance discharge time(P1 = 0.000,?=0.163)drainage tube placement time(P1= 0.001,?= 0.133),total bilirubin in fifth days after operation(P1 = 0.011,?=0.023),postoperative pleural effusion(P1 = 0.000,?=3.605),postoperative pulmonary atelectasis(P1 = 0.000,?=1.939),these indexes are the influencing factors of pulmonary infection after hepatectomy for liver cancer.The statistics of the clinical parameters included in the bivariate correlation analysis showed that: Patient age(P2=0.03,?=0.150),operation distance discharge time(P2=0.00,?=0.359)drainage tube placement time(P2=0.00,?=0.267),total bilirubin in fifth days after operation(P2=0.01,?=0.185),postoperative pleural effusion(P2=0.00,?=0.686),postoperative pulmonary atelectasis(P2=0.00,?=0.301).These indexes have positive correlation with pulmonary infection after liver resection of hepatocellular carcinoma.Postoperative pleural effusion is the highest correlation(?=0.686).4.The results of multivariate Logistic regression analysis were screened out with a statistically significant single factor clinical indicators.Postoperative pleural effusion is an independent risk factor for pulmonary infection after liver resection for liver cancer(P=0.000).5.The basic situation of the independent risk factors and analysis results.Postoperative pleural effusion in patients with independent risk factors,retrospective study of 209 cases of liver cancer patients after liver resection,postoperative pleural effusion 63 cases,the occurrence rate was 30.14%,no pleural effusion was found in 63 patients before operation.,all patients were complicated with pleural effusion,pulmonary infection occurred in 46 of 63 patients with pleural effusion after operation,the occurrence rate was 73.02%.Postoperative patients with pleural effusion,the amount of pleural effusion in the infection group and control group was statistically analyzed: In the small amount of pleural effusion group,there were significant differences between the infection group and the control group(?2=57.42,P=0.00);in the large amount of pleural effusion group,there were significant differences between the infection group and the control group(?2=17.84,P=0.00).Conclusion:1.In this study by our group,the incidence of pulmonary infection after liver resection for liver cancer is high(26.79%).2.Elderly patients,after operation placement of peritoneal drainage tube for a long time,postoperative hospitalization for a long time,postoperative complication with hyperbilirubinemia,postoperative pulmonary atelectasis,these indicators are positive correlation factors of pulmonary infection after liver resection for liver cancer.But in this group,these indexes did not constitute the independent risk factors of pulmonary infection after operation.3.Within the scope of the study factors,postoperative pleural effusion is an independent risk factor for pulmonary infection after liver resection for liver cancer,and after the operation,whether it is to produce a large number of pleural effusion or a small amount of pleural effusion,how much of the amount of the production will not affect the pleural effusion as an independent risk factor for pulmonary infection after liver resection for liver cancer.