低位恶性梗阻性黄疸应用介入引流治疗的预后相关危险因素分析  

The prognostic risk factors of low level malignant obstructive jaundice treated with transhepatic biliary drainage

作　　者：常刚[1] 薛栋[1] 张晓燕[1] 巩曰红[1] 姜在波[2] 

机构地区：[1]山东省滨州市人民医院介入医学科,256610 [2]中山大学附属第三医院介入血管科

出　　处：《中国医师进修杂志》2014年第20期51-54,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨低位恶性梗阻性黄疸应用介入引流治疗的预后相关危险因素。方法回顾性分析2010年1月至2013年6月接受经皮介入引流治疗的142例低位恶性梗阻性黄疸患者的临床资料，以性别、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、血清肌酐、术后胆红素下降程度以及术后是否行抗肿瘤治疗作为研究参数，评估影响其预后的相关危险因素。结果单因素分析结果显示，术前感染（P=0．006）、肝功能Child—Pugh评分（P=0．004）、血清肌酐（P=0．043）、血清总胆红素下降程度（P：0．001）及术后是否行抗肿瘤治疗（P=0．015）是影响低位恶性梗阻性黄疸介入引流治疗患者生存期的相关因素；多因素Logistic回归分析显示，术前感染（0R=3．729，95％C11．332～6．363，P=0．040）、肝功能Child-Pugh评分≥10分（OR=0．513，95％CI0．375～1．276，P：0．018）及术后抗肿瘤治疗（OR=0．668，95％CI0．210～2．026，P=0．038）是影响低位恶性梗阻性黄疸介入引流治疗患者生存期的危险因素。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评分及术后是否行抗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 explore the prognostic risk factors of low level malignant obstructive jaundice treated with transhapetie biliary drainage. Methods The clinical data of 142 patients with low level malignant obstructive jaundice received percutaneous transhapetie biliary drainage management from January 2010 to June 2013 were retrospectively analyzed. The study parameters included gender, age, tumor type, preoperative obstructive time, preoperative infection, drainage method, Child-Pugh grade, serum total bilirubin （TBIL）, albumin （ALB）, serum creatinine （SCr）,the postoperative declining degree of bilirubin and postoperative antineoplastic therapy. The prognostic risk factors were evaluated. Results Single variable analysis showed that preoperative infection （P = 0.006）, Child-Pugh grade （P = 0.004）, SCr（P = 0.043 ）, the postoperative declining degree of TBIL （P = 0.001） and postoperative antineoplastic therapy （P = 0.015） were the related factors for survival time. The further Logistic regression analysis showed that preoperative infection （OR = 3.729,95 % CI 1.332 - 6.363, P = 0.040）, Child-Pugh grade t〉 10 scores （ OR = 0.513,95% CI 0.375 - 1.276, P = 0.018 ） and postoperative antineoplastic therapy （OR = 0.665,95% CI 0.210 - 2.026, P = 0.038） were the related factors for survival time. Conehmion In treating of low level malignant obstructive jaundice with transhapetic biliary drainage,the preoperative infection, Child-Pugh grade and postoperative antineoplastic therapy may be the important related factors that affect the patient＇s survival time, to evaluate the prognosis of these patients has important reference meaning.

关 键 词：黄疸 阻塞性 危险因素 引流术 预后 

分 类 号：R735[医药卫生—肿瘤]