肝门部胆管癌致梗阻性黄疸介入引流治疗的预后分析  

Interventional transhepatic biliary drainage for obstructive jaundice caused by hilar cholangiocarcinoma:an analysis of related factors influencing the prognosis

作　　者：徐川[1] 施海彬[1] 刘圣[1] 杨正强[1] 周卫忠[1] 李麟荪[1] 

机构地区：[1]南京医科大学第一附属医院介入放射科,210029

出　　处：《介入放射学杂志》2012年第9期752-755,共4页Journal of Interventional Radiology

基　　金：江苏高校优势学科建设工程资助项目(JX10231081)

摘　　要：目的探讨影响肝门部胆管癌致梗阻性黄疸介入引流治疗预后的相关危险因素。方法回顾性分析2006年1月—2011年8月在南京医科大学第一附属医院介入放射科接受经皮介入引流治疗的肝门部胆管癌致梗阻性黄疸患者89例,选择性别、年龄、术前梗阻时间、梗阻类型、术前感染、引流方式、肝功能Child-Pugh评分、血清总胆红素、白蛋白、肌酐值,接受引流治疗次数及术后是否针对肿瘤治疗作为研究参数,评估影响该类患者生存期的相关危险因素。结果单因素分析显示梗阻类型(P=0.043)、肝功能Child-Pugh评分(P=0.036)、血清肌酐值(P=0.032)、接受引流治疗次数(P=0.007)及术后是否行抗肿瘤治疗(P=0.015)5个因素是影响该类患者生存期的相关因素。多因素Logistic回归分析显示梗阻部位位于肝总管以上(P=0.037)、肝功能Child-Pugh评分≥10分(P=0.003)、仅接受1次引流治疗(P=0.036)及术后未行抗肿瘤治疗(P=0.021)是影响该类患者生存期的重要因素。结论在对肝门部胆管癌所致梗阻性黄疸介入引流治疗时,梗阻部位、肝功能Child-Pugh评分、接受引流治疗次数及术后是否针对肿瘤治疗可能是影响患者生存期的相关因素,对评估该类患者的预后有重要的参考意义。Objective To investigate the related factors influencing the prognosis of obstructive jaundice caused by hilar cholangiocarcinoma transhapetic biliary treated by interventional transhepatic biliary drainage. Methods During the period from January 2006 to August 2011, a total of 89 patients with obstructive jaundice due to hilar cholangiocarcinoma were admitted to authors＇ hospital to receive interventional transhepatic biliary drainage. The clinical data were retrospectively analyzed. The gender, age, preoperative obstructive time, obstructive type, preoperative infection, drainage methods, Child-Pugh grade, total bilirubin （TBIL）, albumin （ALB）, creatinine （Cr）, number of received drainage procedure and postoperative anti- neoplastic therapy were documented and were used as study parameters, and the related risk factors affecting the survival time were analyzed. Results Single variable analysis showed that the obstructive type（P = 0.043）, Child-Pugh grade（P = 0.036）, Cr （P = 0.032）, number of received drainage procedure （P = 0.007）, postoperative anti-neoplastic therapy （P = 0.015） were the statistically significant related factors that affected patient% survival time. The further Logistic regression analysis indicated that the obstructive position located above the common hepatic duct （P = 0.037）, Child-Pugh grade ≥ 10 （P = 0.003）, receiving a single drainage procedure （P = 0.036） and receiving no postoperative anti-neoplastic therapy （P = 0.021） were the important factors that affected the patient＇s survival time. Conclusion In treating obstructive jaundice due to hilar cholangiocarcinoma transhapetic biliary with interventional transhepatic biliary drainage, the obstructive location, Child-Pugh grade, number of received drainage procedure and postoperative anti-neoplastic therapy may be the related factors that influence the patient＇s survival time, therefore, these parameters are very important reference data in assessing the prognosis. （J Intervent R

关 键 词：胆管癌 肝门部梗阻 黄疸 介入引流 生存期 

分 类 号：R735.8[医药卫生—肿瘤]