基于PSM法探讨原发性肝细胞肝癌患者肝切除术后发生腹腔感染的影响因素OA

Objective To explore the influencing factors of abdominal infection in patients with primary hepatocellular carcinoma after hepatectomy based on the propensity score matching(PSM)method.Methods A total of 605 patients with primary hepatocellular carcinoma admitted to the hospital from January 2019 to December 2024 were selected as the research objects,and all underwent resection surgery.Patients were divided into abdominal infection group and non-abdominal infection group according to whether abdomi-nal infection occurred after resection surgery.PSM method was used to match the patients in the abdominal infection group and the non-abdominal infection group.The clinical data of patients in the abdominal infection group and the non-abdominal infection group before and after matching were compared.Multivariable Logistic regression was used to analyze the influencing factors of abdominal infection in patients with primary hepato-cellular carcinoma after hepatectomy.Results Before matching,the proportion of diabetes mellitus,cirrhosis,intraoperative bile duct treatment,postoperative bile leakage and postoperative ascites,white blood cell count(WBC),systemic immune inflammation index(SII)and C-reactive protein(CRP)in the abdominal infection group were higher than those in the non-abdominal infection group,and the age was older than that in the non-abdominal infection group,and the operation time and drainage tube indwelling time of the abdominal infection group were longer than those of the non-abdominal infection group,and the hemoglobin(Hb)level was lower than that of the non-abdominal infection group,and the differences were statistically significant(P<0.05).And 122 pairs were successfully matched in 605 patients.After matching,the proportions of diabetes mellitus,cirrhosis,Child-Pugh grade C,intraoperative bile duct treatment,postoperative bile leakage and postoperative ascites in the abdominal infection group were higher than those in the non-abdominal infection group,the SII,CRP levels and intraoperative blood loss were higher than those in the non-abdominal infection group,and the operation time and drainage tube indwelling time were longer than those in the non-abdominal infection group,and the Hb level of the group with abdominal infection was lower than that of the non-abdominal infec-tion group,and the differences were statistically significant(P<0.05).Multivariable Logistic regression anal-ysis showed that,diabetes mellitus,cirrhosis,Child-Pugh grade C,increased SII,increased CRP level,intraop-erative bile duct treatment,prolonged operation time,increased intraoperative blood loss,prolonged drainage tube placement time,postoperative bile leakage and postoperative ascites were risk factors for abdominal infec-tion in patients with primary hepatocellular carcinoma after hepatectomy(P<0.05).Increased Hb level was a protective factor for postoperative abdominal infection in patients with primary hepatocellular carcinoma after hepatectomy(P<0.05).Conclusion The PSM method confirmed that postoperative abdominal infection in patients with primary hepatocellular carcinoma after hepatectomy is closely related to preoperative basic con-ditions(diabetes mellitus,cirrhosis,Child-Pugh grade C,Hb),inflammatory state(SII,CRP)and surgery-re-lated factors(intraoperative bile duct management,operation time,intraoperative blood loss,drainage tube placement time,postoperative bile leakage and postoperative ascites).