216例恶性阻塞性黄疸患者手术疗效的因素分析  

Prognostic factors of clinical curative effect for malignant obstructive jaundice

作　　者：邹声泉[1] 秦仁义[1] 王剑明[1] 杨传永[1] 易继林[1] 钱家勤[1] 刘飞龙[1] 覃修福[1] 戴植本[1] 裘法祖[1] 

机构地区：[1]同济医科大学附属同济医院普通外科,武汉430030

出　　处：《中华外科杂志》2000年第10期771-774,共4页Chinese Journal of Surgery

摘　　要：目的　探讨影响恶性阻塞性黄疸临床治疗的预后因素。　方法　对 1990年 1月～ 1997年 12月 2 16例恶性阻塞性黄疸手术患者的 17种临床观察指标进行分析。　结果　 173例 ( 80 1% )手术后 1个月存活 ,发生并发症 81例 ,发生率 37 5 %。根治术者胆管炎、胆瘘、出血、肾功能衰竭等并发症均高于姑息术者 ,差异均有显著性 (P <0 0 1) ;1月生存率和术后并发症发生率与ASA分级、黄疸持续的时间等有明显关系 (P <0 0 1) ;1月生存率与手术类型、黄疸原因无明显关系 (P >0 0 5 ) ;并发症的发生率与手术类型有明显关系 (P <0 0 1)。　结论　恶性阻塞性黄疸患者的手术治疗有机会应尽量行根治性手术 。Objective To explore prognostic factors for clinical treatment of patients with malignant obstructive jaundice. Methods17 variables from 216 consecutive patients with malignant obstructive jaundice admitted from 1990 to 1997 were included for statistical analysis. Results The overall mortality was 19 9% (43/216), and the morbidity 37 5% (81/216). The morbidity of radical operation was higher than that of palliative operation( P <0 01). There was a highly significant correlation between mortality, morbidity , ASA grade and duration of jaundice ( P <0 01). No correlation was seen between the mortality, type of operation and cause of jaundice. There was a highly significant correlation between the morbidity and the type of operation. ConclusionsThe choice of operation in patients with malignant obstructive jaundice is radical operation. Early diagnosis and choice of treatment are essential to improving carative effect.

关 键 词：恶性阻塞性黄疸 外科手术 预后 

分 类 号：R657.4[医药卫生—外科学]