Analysis of short-term and long-term prognosis and influencing factors of primary liver cancer with spontaneous ruptured hemorrhage after emergency TACE surgery
Analysis of short-term and long-term prognosis and influencing factors of primary liver cancer with spontaneous ruptured hemorrhage after emergency TACE surgery
Objective To analyze the short-term and long-term prognosis and influencing factors of primary liver cancer(PLC)with spontaneous ruptured hemorrhage after emergency transcatheter arterial chemoembolization(TACE)surgery.Methods Clinical data of 96 PLC patients with spontaneous ruptured hemorrhage underwent emergency TACE surgery from January 2017 to December 2019 were retrospectively analyzed,and they were included in this study and divided into poor prognosis group(n=45)and good prognosis group(n=51)based on one-year survival status after surgery.Statistical analysis were performed by using SPSS 25.0 software.Count data were expressed as[Example(％)]and were examined by using x2 test;Measurement data exhibiting a normal distribution,were represented by((x)±s),and were exmined by using independent sample t test.By using multiple factor COX regression analysis was performed to identify independent prognostic factors of patients.Furthermore,the area under the curve(AUC)of the receiver operating characteristic(ROC)curve were used to evaluate the predictive value of the mortality of patients within 1 year after surgery.P＜0.05 was considered as a statistically significant difference.Results All patients completed emergency TACE surgery,with a short-term hemostasis success rate of 91.7％.The median survival time of all patients was 10.9 months,and the one-year survival rate after surgery was 46.9％(45/96).Age,the proportions of Child Pugh grade C,TNM stage Ⅳ,portal vein tumor thrombus,the maximum diameter of cancer focus,blood levels of prothrombin time,total bilirubin,glutamic transaminase,creatinine and alpha-fetoprotein in poor prognosis group were significantly higher than those in the good prognosis group,and the blood level of hemoglobin(HB)and prognostic nutritional index(PNI)were significantly lower than those in the good prognosis group(P＜0.05).The multivariate COX regression analysis result showed that Child Pugh grade,TNM stage,preoperative Hb and PNI were the independent influencing factors for the prognosis of patients after emergency TACE surgery(P＜0.05).The ROC curve analysis result indicated that Hb and PNI before emergency TACE have high predictive value for mortality within one-year after surgery(P＜0.05).Conclusion The short-term hemostatic effect of emergency TACE for PLC patients with spontaneous ruptured hemorrhage is good,and Child Pugh grade,TNM stage,preoperative Hb and PNI were the independent influencing factors for postoperative prognosis of patients.
关键词
原发性肝癌/经导管动脉化疗栓塞/自发性破裂出血/急诊手术/预后/影响因素分析
Key words
Primary Liver Cancer/Transcatheter Arterial Chemoembolization/Spontaneous Ruptured Hemorrhage/Emergency Surgery/Prognosis/Root Cause Analysis
维普
万方数据