恶性梗阻性黄疸介入治疗短期预后的多因素分析  

Factors influencing the short-term prognosis of interventional therapy for malignant obstructive jaundice: a multivariate analysis

作　　者：张学强[1] 翟仁友[2] 

机构地区：[1]河北省邢台医学高等专科学校第二附属医院介入放射科,054000 [2]首都医科大学附属北京朝阳医院介入放射科

出　　处：《介入放射学杂志》2009年第11期846-849,共4页Journal of Interventional Radiology

基　　金：国家十一五科技支撑计划课题(2007BAI05B06)

摘　　要：目的探讨影响恶性梗阻性黄疸经皮肝穿胆道引流或(和)胆道支架置入术近期预后的相关因素。方法分析2008年12月至2009年6月经PTBD或(和)PTBS治疗的梗阻性黄疸患者67例,参照胆红素下降程度和术后30 d内生存情况分为短期治疗有效(54例)和无效(13例)2组,应用χ2进行单因素分析,非条件Logistic进行多因素分析。结果单因素分析方法显示患者梗阻时间、引流方式、术前胆道感染和肝功能Child-Pugh评分、TBIL、HGB、Cr 7个因素有统计学意义。多因素分析示术前胆道感染、肝功能Child-Pugh评分≥11分、Cr>115μmol/L 3个因素有统计学意义。结论术前胆道感染、肝功能Child-Pugh评分≥11分、Cr>115μmol/L与梗阻性黄疸短期预后关系密切,对梗阻性黄疸介入治疗的术前评估有重要参考意义。Objective To discuss the correlative factors affecting the short-term prognosis in treating malignant obstructive jaundice with percutaneous transhepatic biliary drainage（PTBD） and / or percutaneous transhepatic biliary stenting（PTBS）.Methods During the period of December 2008-June 2009,PTBD and / or PTBS were performed in 67 patients.The clinical date were reviewed and analyzed.According to the reduction degree of serum bilirubin and survival condition in 30 days,the patients were divided into effective group（54 cases） and ineffective group（13 cases）.Single factor affecting the short-term prognosis was analyzed by using χ2 test and multi-factors were analyzed by using non-conditional logistic regression mode.Results Single variable analysis showed that time of obstruction,way of drainage,preoperative biliary infection,Child-Pugh grade,TBIL,HGB and Cr level were of statistical significance.The logistic regression analysis showed that there were obvious correlation among preoperative biliary infection,Child-grade ≥ 11 and Cr 〉 115 μmol / L.Conclusion The infection of the bile duct before operation,Child-grade ≥ 11 and Cr 〉115μmol / L carry a close relationship with the short-term prognosis of PTBD and PTBS.Therefore,an overall preoperative evaluation for malignant obstructive jaundice is of great importance.

关 键 词：恶性梗阻性黄疸 介入治疗 胆道引流 短期预后 

分 类 号：R735[医药卫生—肿瘤]