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目的探讨肝细胞癌切除术后早期和后期死亡的不同危险因素,为临床干预提供依据。方法回顾性分析1996年1月-2003年12月我院肝胆外科174例手术切除肝细胞癌病例的临床和病理资料,将其分为早亡组(术后生存时间≤2年,n=61),后亡组(2年<术后生存时间≤5年,n=29)和5年生存组(术后生存时间>5年,n=84),比较相关资料,并结合随访结果进行危险因素及预后分析。结果多因素分析显示大血管侵犯、肿瘤低分化、大直径肿瘤和男性为早期死亡危险因素;而血清高GGT值为后期死亡的危险因素。结论早期死亡和肿瘤因素密切相关,应加强术后继续治疗;后期死亡则与病肝状态相关,血清GGT可能有预测价值。
Objective To investigate the risk factors of early and late postoperative death of hepatocellular carcinoma and provide evidence for clinical intervention. Methods The clinical and pathological data of 174 hepatocellular carcinoma cases from January 1996 to December 2003 in our hospital were retrospectively analyzed and divided into premature death group (postoperative survival time ≤ 2 years, n=61 ), After death group (2 years 5 years, n=84), compare relevant data, and combine the results of follow-up Factors and prognosis analysis. Results Multivariate analysis showed that macrovascular invasion, poorly differentiated tumors, large-diameter tumors and men were risk factors for early death, and serum high GGT was a risk factor for later death. Conclusion Early death and tumor factors are closely related, postoperative continuous treatment should be strengthened; late death is related to disease liver status, and serum GGT may have predictive value.