关键词: 肝内胆管结石, 肝切除, 术后感染性并发症, 危险因素, 列线图

Abstract: Objective To investigate the risk factors of infectious complications after hepatectomy in patients with intrahepatic bile duct stones.Methods The clinical data of 592 patients with intrahepatic bile duct stones who underwent hepatectomy were collected.According to whether there were infectious complications after hepatectomy,the patients were divided into infected group and uninfected group.The risk factors that may affect the occurrence of postoperative infectious complications were analyzed by univariate and multivariate logistic regression.Meanwhile,a nomogram visual prediction model was established,and the prediction efficiency of the model was evaluated by c-index value.Results The incidence of infectious complications after hepatectomy was 16.55%.Logistic regression analysis showed that preoperative serum albumin(Alb) level,combined with biliary cirrhosis,operation distance from acute cholangitis control interval,cholangiojejunostomy,rapid rehabilitation Surgical Nursing(preoperative diet control,preoperative intestinal preparation Intraoperative management) was a predictor of infectious complications after hepatectomy in patients with intrahepatic bile duct stones.Based on the nomogram constructed by the above five risk factors,the training set c-index is 0.825(95%CI 0.321 ~ 1.329),and Hosmer lemeshow deviation detection χ²=8.773(P＞0.05).The c-index value of the validation set was 0.813(95%CI 0.284 ~ 1.342),Hosmer lemeshow deviation detection χ²=8.931(P＞0.05).Conclusion Nomogram prediction model can effectively predict the risk of infectious complications after hepatectomy in patients with intrahepatic bile duct stones.Rapid rehabilitation surgical nursing is an important part of nursing after hepatectomy for intrahepatic bile duct stones.Its implementation effect is closely related to the risk of postoperative infectious complications.

Key words: intrahepatic bile duct stones, hepatectomy, postoperative infectious complications, risk factors, nomogram