摘要
Abstract
Objective To investigate the efficacy of percutaneous transhepatic biliary drainage ( PTBD) in treat-ment of malignant obstructive jaundice ( MOJ) , and to analyze the influencing factors of efficacy in order to provide theo-retical basis for the clinical treatment. Methods Clinical data of 122 MOJ patients admitted during January 2010 and January 2014 was retrospectively analyzed, and all patients received PTBD, and then all were followed up after the sur-gery. The levels of total bilirubin ( TB) , direct bilirubin and indirect bilirubin were compared before and 1 week after the surgery, and factor records such as gender, age, Karnofsky performance status ( KPS) score, the values of cholangiecta-sis degree, liver function, TB and biliary tract infection before the surgery, Bismuth typing, and postoperative complica-tions, obstruction positions, unilateral and bilateral drainage methods were collected, which might affect the efficacy. The single factor and logistic regression analyses were performed between TB and different influencing factors 1 week after the surgery. Results ①One week after the surgery, the TB, direct bilirubin and indirect bilirubin levels were significantly lower than those before surgery (P<0. 01), and there were 87 patients (71. 31%) with good efficacy and 35 patients (28. 69%) with poor efficacy. The average survival time was (11. 60 ± 2. 15) month. ②The single factor and Logistic regression analyses showed that the preoperative KPS score, liver function and TB level, and postoperative complications were the risk factors influencing the efficacy (P<0. 05, P<0. 01). Conclusion The percutaneous transhepatic biliary drainage in treatment of malignant obstructive jaundice has obvious efficacy, and therefore it is significant to improve prognosis by preoperative improvement of physical ability, positive hepatoprotection therapy, early PTBD therapy and postoperative infection prevention.关键词
恶性梗阻性黄疸/经皮肝穿刺胆管引流术/治疗结果/影响因素分析Key words
Malignant obstructive jaundice/Percutaneous transhepatic biliary drainage/Treatment outcome/Root cause analysis分类
医药卫生
