低位恶性梗阻性黄疸242例介入引流治疗的预后分析  

Transhepatic biliary drainage for the treatment of low position malignant obstructive jaundice: an analysis of related factors influencing the prognosis

作　　者：徐川[1] 施海彬[1] 刘圣[1] 杨正强[1] 夏金国[1] 周春高[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》2013年第2期133-136,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：目的探讨低位恶性梗阻性黄疸介入引流治疗与预后相关的危险因素。方法回顾性分析2005年9月—2011年12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低位恶性梗阻性黄疸患者242例,选择性别、年龄、肿瘤类型、术前梗阻时间、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、术后胆红素下降程度以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术前感染(P=0.005)、肝功能Child-Pugh评分(P=0.003)、血清肌酐(P=0.044)、血清胆红素下降程度(P=0.000)及术后是否行抗肿瘤治疗(P=0.014)5个因素是影响该类患者生存期的相关因素;多因素Logistic回归分析显示术前感染(P=0.041)、肝功能Child-Pugh评分≥10分(P=0.019)及术后未行抗肿瘤治疗(P=0.039)是影响该类患者生存期的重要因素。结论在对低位恶性梗阻性黄疸介入引流治疗时,术前感染、肝功能Child-Pugh评分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 discuss the related factors influencing the prognosis of low position malignant obstructive jaundice treated with transhapetic biliary drainage. Methods During the period from September 2005 to December 2011, a total of 242 patients with low position malignant obstructive jaundice were admitted to authors＇ hospital. All the patients received percutaneous transhapetic biliary drainage management. The clinical data were retrospectively analyzed. The study parameters included gender, age, tumor type, preoperative obstructive time, preoperative infection, drainage method, Child-Pugh grade, total bilirubin （TBIL）, albumin （ALB）, creatinine （Cr）, the postoperative declining degree of bilirubin and postoperative antineoplastic therapy. The possible related risk factors affecting the survival time were statistically analyzed. Results Single variable analysis showed that preoperative infection （P = 0.005）, Child-Pugh grade （P = 0.003）, Cr （P = 0.044）, the postoperative declining degree of bilirubin （P = 0.000） and postoperative antineoplastic therapy （P = 0.014） were the related factors that would significantly affect the patient＇s survival time. The further Logistic regression analysis showed that preoperative infection （P = 0.041）, Child-Pugh grade ≥ 10 （P = 0.019） and no use of postoperative anti-neoplastic therapy （P = 0.039） were the important related factors that would significantly affect the patient＇s survival time. Conclusion In treating low position malignant obstructive jaundice with transhapetic biliary drainage, the preoperative infection, Child- Pugh grade and postoperative use of antineoplastic therapy may be the important related factors that affect the patient＇s survival time. These parameters are of great value in estimating the patient＇s prognosis.

关 键 词：低位梗阻 黄疸 介入引流 生存期 

分 类 号：R735.7[医药卫生—肿瘤]