Objective To investigate prognostic factors for patients with hepatic encephalopathy（HE）and hepatocellular carcinoma（HCC）undergoing Liver transplantation. Methods Retrospectively we analyzed the clinical data and survival outcomes of 292 patients with hepatic cirrhosis and primary hepatocellular carcinoma who underwent first liver transplantation in Tianjin First Center Hospital. Kaplan-Meier survival curves were established to compare the 5-year survival of patients with or without HE. Univariate and multivariate Cox proportional hazard models were performed to identify independent risk factors for poor outcomes. Results The overall long-term survival rate of patients in HE group was not lower than that in none-HE group. Univariate analysis showed that thehigh risk index of tumor prognosis was AFP ＞ 1 000 μg/L，portal vein embolization，TNM staging，stage Ⅲ，Ⅳ stage，moderate differentiation and low differentiation. Independent risk factors for postoperative cumulative survival included AFP，tumor size，differentiation，portal vein thrombosis，and TNM staging. Conclusion HE is not a major risk factor effecting post-transplant mortality of patients with HCC. Presence of HE improve detection rate of early HCC. Positive control of HE during pre-transplant period is beneficial for prognosis.

目的 探讨肝癌（HCC）患者肝移植（LT）术后生存率的影响因素，并分析术后生存率与 肝性脑病（HE）的潜在联系。方法 回顾性分析 2008 年 1 月— 2010 年 12 月天津市第一中心医院肝胆外 科收治的 292 例单中心肝硬化合并 HCC 行肝移植术的患者的临床资料。比较两组受者各项指标有无统计 学差异，Kaplan-Meier 方法对全体研究对象进行单因素生存分析，应用 Cox 比例风险模型进行多因素分析。 结果 共纳入 292 例患者的临床资料，其中伴 HE 者 52 例，无 HE 者 240 例。HCC 伴 HE 组患者术后生 存率高于 HCC 不伴 HE 组患者。单因素分析 ：肿瘤预后高危指标包括 AFP ＞ 1 000 μg/L，有门静脉栓塞， TNM 分期Ⅲ、Ⅳ期，中、低度分化 ；Cox 回归分析 ：影响 HCC 患者移植术后生存率的独立危险因素包括甲 胎蛋白（AFP），肿瘤大小，分化程度，门静脉栓塞，TNM 分期。结论 HE 是影响肝癌患者肝移植术后生 存率的非主要因素。并发 HE 的肝癌患者可提高早期癌症检出率。围术期积极防控 HE，及早采取肝移植术 治疗可获良好结果。