转移性肝癌合并肝性脑病短期内死亡风险的潜在影响因素研究

肝脏 ›› 2021, Vol. 26 ›› Issue (6): 646-649.

转移性肝癌合并肝性脑病短期内死亡风险的潜在影响因素研究

李飞龙, 张子倩

067000 河北承德中国人民解放军联勤保障部队第九八一医院肿瘤科

收稿日期:2020-09-02 出版日期:2021-06-30 发布日期:2021-07-19
通讯作者: 李飞龙,Email:1036672639@qq.com

A study about the potential influencing factors for short-term mortality risk of metastatic liver cancer complicated with hepatic encephalopathy

LI Fei-long, ZHANG Zi-qian

Department of Oncology, 981 Hospital of the Joint Logistic Support Force of Chinese People's Liberation Army, Chengde, Hebei 067000, China

Received:2020-09-02 Online:2021-06-30 Published:2021-07-19
Contact: LI Fei-long,Email:1036672639@qq.com

摘要/Abstract

摘要： 目的分析转移性肝癌合并肝性脑病短期内死亡风险的潜在影响因素。方法以医院2017年1月至2019年12月收治的125例转移性肝癌合并肝性脑病患者为研究对象,按照患者预后分为存活组、死亡组,分析两组临床资料,总结影响预后的危险因素。结果存活组、死亡组Child-Pugh分级、肝性脑病分级结果存在统计学差异(P<0.05),但肝癌分型、肿瘤直径、肿瘤位置结果均不存在统计学差异(P>0.05);存活组、死亡组PT、BUN、胆碱酯酶水平差异明显(P<0.05),但ALT、AST、血氨、血钠水平差异不大(P>0.05);存活组与死亡组在合并肝癌合并肝硬化、肝癌合并症数量比较存在统计学差异(P<0.05),而在合并门静脉合并癌栓、肝外转移、腹腔淋巴结转移结果无统计学差异(P>0.05);Logistic多因素回归分析显示肺癌合并症3个及以上、肝性脑病分期Ⅲ与Ⅳ期、Child-Pugh分级为C级是影响转移性肝癌合并肝性脑病短期内死亡的独立风险因素(P<0.05)。结论转移性肝癌合并肝性脑病短期内死亡的独立风险因素有多种,临床对于这类患者应做好密切监测与干预,控制风险因素,以最大可能减少患者死亡,改善预后。

关键词: 转移性肝癌, 肝性脑病, 短期, 死亡风险, 潜在影响因素

Abstract: Objective To analyze the potential influencing factors for short-term mortality risk of metastatic liver cancer complicated with hepatic encephalopathy.Methods A total of 125 patients with metastatic hepatocellular carcinoma complicated with hepatic encephalopathy admitted to our hospital from January 2017 to December 2019 were enrolled as the research subject. They were divided into survival group and death group according to the prognosis. The clinical data of the 2 groups were analyzed to summarize the risk factors of prognosis.Results There were statistical differences in Child-Pugh score and liver encephalopathy classification between survival group and death group (P<0.05). And there was no statistical difference in liver cancer classification, tumor diameter, or tumor location between 2 groups (P>0.05). The levels of prothrombin time, blood urea nitrogen, and cholinesterase were significantly different between 2 groups (P<0.05). There was no significant difference in the levels of alanine transaminase, glutamic oxalacetic transaminase, blood ammonia, or blood sodium (P>0.05). There was statistical difference in the incidence of liver cancer complicated with cirrhosis and the number of comorbidities (P<0.05). There was no statistical difference in the incidences of portal vein thrombosis, extrahepatic metastasis, or abdominal lymph node metastasis (P>0.05). Multivariate logistic regression analysis indicated that cancer comorbidities ≥ 3, Ⅲ or Ⅳ stage of hepatic encephalopathy and Child-Pugh grade C were independent risk factors for short-term mortality of metastatic liver cancer complicated with hepatic encephalopathy (P<0.05).Conclusion There are many independent risk factors for short-term mortality of metastatic liver cancer with hepatic encephalopathy. Such patients need close monitoring and intervention to reduce the risk of death and to improve the prognosis.

Key words: Metastatic liver cancer, Hepatic encephalopathy, Short-term, Risk of death, Potential influencing factors

李飞龙, 张子倩. 转移性肝癌合并肝性脑病短期内死亡风险的潜在影响因素研究[J]. 肝脏, 2021, 26(6): 646-649.

LI Fei-long, ZHANG Zi-qian. A study about the potential influencing factors for short-term mortality risk of metastatic liver cancer complicated with hepatic encephalopathy[J]. Chinese Hepatolgy, 2021, 26(6): 646-649.

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