介入治疗高位恶性梗阻性黄疸近期疗效的多因素分析  

Short-term efficacy of interventional therapy for malignant obstructive jaundice with hilar biliary obstruction： a multivariate analysis

作　　者：顾潍炜 杨正强[2] 施海彬[2] 黄健[1] 赵辉[1] 

机构地区：[1]南通大学附属医院介入放射科,江苏南通226001 [2]南京医科大学第一附属医院介入放射科

出　　处：《实用放射学杂志》2013年第12期2013-2016,共4页Journal of Practical Radiology

基　　金：江苏省卫生厅科技兴卫工程领军人才项目（LJ201119）.

摘　　要：目的研究影响经皮肝穿刺胆道引流（percutaneous transhepactic biliary drainage,PTBD）治疗高位恶性梗阻性黄疸近期预后的相关因素。方法同顺分析水科经PTBI）治疗的高位恶性梗阻性黄疽患者52例。男32例,女20例，年龄39～79岁,平均60岁。选择年龄、性别、肝脏储备功能、Karnofsky体能评分、血清总胆红素、血清肌酐、术前胆道感染、左右肝管是否相通8个因素作为研究参数,评估影响该类患者近期疗效的相关危险因素。结果单因素分析显示患者肝脏储备功能、体能评分、总胆红素、肌酐、胆道感染等5个因素与近期预后的关系有统计学意义（P〈0．05）。多因素分忻示肝脏储备功能Child—Pugh评分≥10分、肌酐〉115Mmol／L、体能KPS评分≤50等3个因素与近期死亡牢的关系有统计学意义。结论肝脏储备功能、肌酐、体能评分与PTBD治疗高位恶性梗阻性黄疸患者的近期预后关系密切。Objective To study the correlative factors of the short-term prognosis in patients with malignant obstructive jaundice treated with minimally invasive percutaneous transhepatic biliary drainage （PTBD）. Methods 52 patients with malignant obstructive jaundice due to hilar biliary obstruetion treated by PTBD were enrolled in the study. Eight indexes including the age, gender, Child Pugh grade, Karnofsky physicalscore （KPS）, serum total bilirubin （TBIL） and creatinine （Cr） levels, history of preoperativeinfec tion and the separated obstruction of bilateral biliary ducts were used, and the related risk factors of the short-term prognosis were analyzed. Results Single variable analysis showed that biliary infection, Child Pugh grade, TBIL, Cr and KPS were related to the short term prognosis（P〈0.05）. The logistic regression analysis showed that Child Pughgrade≥10, Cr〉115 μmol/Land KPS≤50 were correlated with short term mortality. Conclusion The Child Pugh grade≥10, Cr〉l15 μmol/L and KPS≤50 were associated closely with the short term prognosis of PTBD.

关 键 词：梗阻性黄疸 介入治疗 经皮肝穿刺胆道引流术 预后 

分 类 号：R575[医药卫生—消化系统] R815[医药卫生—内科学]