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Objective To Analysis the prognostic factors of pediatric liver failure.Method All of the 76 cases are analyzed by using EXCEL and SPSS18.0 software, measurement data is analyzed byΧ~2 test; categorical data is analyzed by T test; Multifactor is analyzed by Logistic regression analysis.Results We analyse 76 children who had liver failure and hospitalized in Children’s hospital affiliated Chongqing medical university within ten years, 45 boys and 31 girls. The youngest one only 5 days old, the oldest one 16 years old, the average age is 4. 4.The survival rate of liver failure in children is only 17.1%, jaundice,digestive symptom, weak, ascites, hemorrhage, hepatic encephalopathy are the main clinical manifestation. Among the liver failure children, 32 children(42.1%)with liver failure can not find the pathogen; 13 children infact CMV(17.1%), one combine congenital biliary malformation; Seven patients(9.2%)have congenital biliary malformation; Five children(6.6%)infact epstein-barr virus; Seven children(9.2%)infact hepatitis B virus, one combine hepatitis A virus; Ten children who get hepatitis A virus, hepatitis E virus infaction, toxoplasmosis, hepatolenticular degeneration(HLD), Paraquat poisoning or DOF are dead. One bee sting, one fish gall bladder poisoning are survival. Pathogens had been found or not has not significant correlated with prognosis(P=0.127).71 patient had less than 4 complications, 18.3% survival, 5 patient had more than 3 complications,100% dead,two groups has significantly correlated with prognosis(P=0.000).We choose MELD and CTP score systems to assess prognosis, two of them all have not significant correlated with prognosis between groups analysis, but CTP score has significant correlated with prognosis by using one-factor analysis(P=0.022).21 children(27.6%)are treated only by medicine,two (9.5%)are survival;43 children(56.6%)are treated by medicine and blood products,Eight(18.6%)are survival;12 children (15.8%)combine artificial liver treatment,three are survival(25%)。Among the three groups,there is no significances in statistics(P=0.458)。Univariate statistical analysis shows that the factors significantly correlated with prognosis are age, disease types,stage, total bilirubin , prothrombin activity, albumin, bile acid, hepatic encephalopathy , complication and CTP score. (each P value is 0.028、0.036、0.013、0.022、0.013、0.037、0.023、0.002、0.008、0.021);Multivariate statistical analysis shows that the factors significantly correlated with death are ag(eP=0.030), disease stage(P=0.006)and hepatic encephalopathy(P=0.011).Conclusion The mortality rate with Liver failure in children is high. Many patients could not find the pathogen. For the patients who we find the pathogen , CMV, congenital biliary malformation, HBV and EBV infaction are the most common causes. More complications appear, worse prognosis we find. The factors significantly correlated with prognosis are age, disease stage and hepatic encephalopathy. It is meaningful for diagnose and treatment by analyzing these prognostic factors.
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