Objective To analyze the influencing factors of abdominal infection after anatomical hepatectomy,and the predictive value of early serum indices.Methods A total of 100 patients with anatomical hepatectomy were divided into the infected group(n=25)and the non-infected group(n=75)based on the presence or absence of abdominal infection after operation.The etiological characteristics of abdominal infection were analyzed,and clinical data such as gender,age,preoperative albumin(Alb),and surgical related indicators were compared between the infected group and non-infected group.The factors influencing abdominal infection were analyzed,and the prognosis and changes in liver function[total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and prothrombin time(PT)]between the infected group and the non-infected group were compared.The early infectious serum indices[C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]of the two groups were detected,and the predictive value of average CRP,PCT,IL-6,and TNF-α within the third day after operation for abdominal infection was analyzed.Results Twenty-five patients(25.00％)were infected with abdominal infection.42 pathogenic bacteria strains were detected,including 20 Gram-negative bacteria strains and 22 Gram-positive bacteria strains.Age,diabetes,operation time,intraoperative colloid usage,cholangiotomy and drainage or cholangiojejunostomy were independent risk factors for abdominal infection,while serum Alb was a protective factor(P＜0.05).Hospitalization time of the infected group was longer than that of the non-infected group,and hospitalization cost of the infected group was higher than that of the non-infected group(P＜0.05).The preoperative DBIL,ALT,and DBIL on the first day after operation in the infected group were higher than those in the non-infected group(P＜0.05).There was no significant difference in 28-day mortality between the two groups(P＞0.05).The levels of CRP,PCT,IL-6,and TNF-α in the infected group were higher than those in the non-infected group before operation and on the first and third day after operation(P＜0.05).The area under the ROC curve(AUC)of mean CRP,PCT,IL-6,and TNF-α for predicting abdominal infection within three days after operation were 0.821,0.817,0.813,and 0.772,respectively.Conclusion Age,diabetes,and operation time are influencing factors of abdominal infection after anatomical hepatectomy.The detection of CRP,PCT,IL-6,and TNF-α is of predictive value for early abdominal infection.
anatomical hepatectomyabdominal infectioninfluencing factorserum indicespredictive value
维普
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