摘要
Abstract
Objective To investigate the clinical significance of Child score and MELD score in patients with liver cirrhosis before cholecystectomy risk assessment. Methods Sixty-seven cases of liver cirrhosis complicated with gallbladder disease in our hospital were performed cholecystectomy and the clinical data were analyzed retrospectively. According to Child-Pugh classification criteria and MELD score were respectively assigned to 3 groups (Child A, Child B, Child C, and MELD<10, 10≤MELD<20, MELD≥20). ALT, TBiL, ALB, PT and SCr indexes were detected by ELISA and the post-operative complications in 3 days after surgery were recorded and assessed. Results There were significant differences in ALT, TBiL between A and B levels in the Child groups (all P values<0.05), but there was no significant difference in ALB, PT, SCr (P>0.05). There were significant differences in levels of ALT, TBiL, ALB, PT and SCr indexes among MELD groups (all P values <0.05). Complications occurred in 9 cases. A cording to Child score, there were 2 cases of ascites in group Child A, one cases of ascites complicated with DIC in group Child A, 4 cases of ascites in group Child B (2 died of DIC), 2 cases of ascites in group Child C (one case was ascites complicated with DIC and survived, and another one died of ascites complicated with liver failure and live-kidney syndrome). A cording to MELD score, there were one cases of ascites in group MELD<10, 5 cases of ascites in group 10≤MELD<20 in which 2 complicated with DIC; 3 cases with ascites in group MELD≥20 (2 cases of DIC and one cases of ascites complicated with liver failure and live-kidney syndrome were dead). Conclusion MELD scoring system seemed better risk assessment for cholecystectomy in patients with liver cirrhosis, and the combined Child-pugh score was more accurate to predict the incidence of postoperative complications.关键词
终末肝病模型/Child/肝硬化/胆囊切除术Key words
MELD/Child/Liver cirrhosis/Cholecystectomy分类
医药卫生
