探究离体肝切除自体肝移植术治疗终末期肝泡型包虫病患者术后生存时间的影响因素，评价其经济和社会效益。

回顾性分析新疆医科大学第一附属医院肝病科2011年5月至2016年5月完成的30例行离体肝切除自体肝移植术治疗终末期肝泡型包虫病患者的临床资料。分析性别、年龄、手术时间、术中红细胞输注量、术中尿量、术中出血量、无肝期时间、无肝期尿量、术后并发症、术后住院时间及住院总费用等指标。采用Kaplan-Meier法进行单因素分析，初步筛选生存时间的影响因素，将单因素分析中有统计学意义的因素纳入Cox比例风险模型进行多因素分析，P<0.05为差异有统计学意义。

30例受者平均手术时间为(15.3±2.6)h (7.9～22.3 h)，术中平均红细胞输注量为(11±6)U (0～32 U)，术中平均尿量为(4 020±1 299)mL (450～11 750 mL)，术中平均出血量为(2 498±2 160)mL (400～15 000 mL)，无肝期中位时间为330 min (104～879 min)，无肝期平均尿量为(1 397±480)mL (450～3 200 mL)，术后中位住院时间为33 d (3～183 d)，术后中位住院费用为22万元(9～84万元)，术后并发症发生人数18例。单因素分析结果显示：年龄、术中出血量、手术时间及无肝期时间与受者术后生存时间有关(P均<0.05)；性别、术中红细胞输注量、术中尿量及无肝期尿量与受者术后生存时间无关(P均>0.05)。Cox比例风险模型分析结果表明，术中出血量是影响受者术后生存时间的独立危险因素(P<0.05)。

术中出血量是影响离体肝切除自体肝移植术治疗终末期肝泡型包虫病患者术后生存时间的独立危险因素。该术式具有良好的经济和社会效益，是治疗终末期泡型包虫病的理想手术方式。

To explore the influence factors of postoperative surviral time of end stage liver alveolar echinococcosis patients treating with ex-vivo liver resection and autologous liver transplantation, and trying to evaluate economical and social benefit.

The clinical data of 30 end stage liver alveolar echinococcosis patients treating with ex-vivo liver resection and autologous liver transplantation in the First Affiliated Hospital of Xinjiang Medical University during May 2011 and May 2016 was analyzed retrospectively. Indexes including gender, age, operation time, time of anhepatic phase, erythrocyte transfusion, bleeding volume and urine output during operation, urine output during anhepatic phase, complication and hospital stay after operation, and hospitalization expenses were analyzed. Single-factor analysis was conducted by Kaplan-Meier test and factors which had statistical significance were involved in Cox proportional hazard model for multiple-factor analysis. P<0.05 was deemed statisticaly significant.

The mean operation time, median time of anhepatic phase, mean erythrocyte transfusion during operation, mean urine output during operation, mean bleeding volume during operation, mean urine output during anhepatic phase, median time of hospital stay and median expenses of hospitalization of 30 patients were (15.3±2.6) h (7.9-22.3 h), 330 min (104-879 min), (11±6) U (0-32 U), (4 020±1 299) mL (450-11 750 mL), (2 498±2 160) mL (400-15 000 mL), (1 397±480) mL (450-3 200 mL) and 33 d (3-183 d), 22 thousand yuan (9-84 thousand yuan), respectively. Postoperative complication developed in 18 patients. The results of single-factor analysis showed that indexes including age, time of anhepatic phase, operation time and urine output during operation were related to postoperative surviral time (P all<0.05); and indexes like gender, erythrocyte transfusion during operation, urine output during operation and urine output during anhepatic phase had no relationship with postoperative surviral time (P all>0.05). The results of Cox proportional hazard model showed that bleeding volume during operation was an independent risk factor for postoperative surviral time (P<0.05).

Bleeding volume during operation is an independent risk factor which influences postoperative surviral time of end stage liver alveolar echinococcosis patients treating with ex-vivo liver resection and autologous liver transplantation. This ideal surgical method has good economical and social benefit.