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目的总结76例儿童肝衰竭临床资料,探讨影响儿童肝衰竭预后的相关因素。方法选择重庆医科大学附属儿童医院2001年6月至2010年11月收治的76例病历资料,用EXCEL及SPSS18.0软件分析,单因素分析用累积比数logistic回归模型分析,多因素分析用logistic回归模型分析。结果 (1)儿童肝衰竭治疗好转、治愈率低(17.1%)。(2)本组病例病因不明32例(42.1%),病因明确44例(57.9%),胆道畸形、巨细胞病毒、乙型肝炎病毒及EB病毒感染占72.7%。(3)使用非生物型人工肝治疗12例(15.8%),治疗显效2例,有效1例,治疗无效9例。(4)单因素分析提示,年龄、凝血酶原时间活动度(PTA)、白蛋白、肝性脑病、住院时间、并发症的种数对预后的影响有统计学意义(P均<0.05);多因素分析提示,肝性脑病、住院时间是影响患儿预后的独立危险因素(P均<0.05)。结论儿童肝衰竭病情进展快、病死率高,病因不明确占多数,肝性脑病、住院时间是影响患儿预后的独立危险因素。分析各种因素对儿童肝衰竭预后的影响可为疾病的诊断、治疗提供帮助。
Objective To summarize the clinical data of 76 children with liver failure and to explore the related factors that affect the prognosis of children with liver failure. Methods Sixty-six cases of patients admitted from June 2001 to November 2010 in Children’s Hospital of Chongqing Medical University were analyzed by EXCEL software and SPSS18.0 software. Univariate analysis was performed using cumulative logistic regression model. Multivariate analysis was performed using logistic regression analysis. Regression model analysis. Results (1) Children with liver failure improved, the cure rate was low (17.1%). (2) 32 cases (42.1%) had unknown etiology, 44 cases (57.9%) had clear etiology, 72.7% had biliary tract malformation, cytomegalovirus, hepatitis B virus and Epstein-Barr virus infection. (3) 12 cases (15.8%) were treated with non-biological artificial liver, 2 cases were markedly effective, 1 case effective, and 9 cases were ineffective. (4) Univariate analysis showed that the effects of age, prothrombin time activity (PTA), albumin, hepatic encephalopathy, hospitalization time and number of complications on prognosis were statistically significant (all P <0.05). Multivariate analysis suggested that hepatic encephalopathy and hospital stay were independent risk factors affecting the prognosis of children (all P <0.05). Conclusion The progress of children with liver failure is fast, the mortality rate is high, the etiology is not clear, and the majority of hepatic encephalopathy and hospitalization are the independent risk factors affecting the prognosis of children. Analysis of various factors on the prognosis of children with liver failure for diagnosis and treatment of diseases to help.