临床小儿外科杂志2025，Vol.24Issue(1)：30-34,5.DOI:10.3760/cma.j.cn101785-202405016-006
胆道闭锁Kasai手术后未发生胆管炎患儿的近中期疗效及影响因素分析
Analysis of short/medium-term effectiveness and influencing factors after Kasai surgery in patients with biliary atresia without cholangitis
摘要
Abstract
Objective To explore the short/medium-term efficacies and influencing factors after Kasai surgery in children with biliary atresia(BA)without cholangitis.Methods From November 2016 to October 2022,the clinical data were retrospectively reviewed for 70 type Ⅲ BA children without cholangitis after Kasai surgery.According to early bile drainage status,they were assigned into two groups of early bile drainage-good(EBD-G,n=25)and early bile drainage-poor(EBD-P,n=45).Two groups were compared with regards to general profiles,preoperative liver function parameters,degree of hepatic fibrosis and postoperative rate of native liver survival(NLS).Results There were 31 boys and 39 girls.NLS rates at Month 6 and Year 1/3/5 post-operation were 68.6％,51.4％,48.3％and 48.3％.NLS rates at Month 6 and Year 1/3/5 post-operation were 100％,95.8％,95.8％,95.8％and 51.1％,26.7％,22.2％,22.2％in EBD-G and EBD-P groups.NLS rate of EBD-G group was higher than that of EBD-P group with statistically significant differences(P＜0.001).In EBD-P group,day age during Kasai surgery[(69.60±14.82)vs.(61.84±14.96)day],body weight[(4.95±0.69)vs.(4.57±0.66)kg]and preoperative aspartate aminotransferase(AST)[(246.27±101.04)vs.(178.20±64.45)U/L]were higher than those within EBD-G group and the difference was statistically sig-nificant(P＜0.05).Preoperative level of γ-glutamyl transferase(GGT)was higher in EBD-G group than that in EBD-P group[654.00(391.00,803.00)vs.340.00(160.00,460.00)U/L]and there was statistically sig-nificant difference(P＜0.05).Conclusions Early bile drainage is an important factor affecting NLS in chil-dren without cholangitis after Kasai surgery.Operative age,body weight and preoperative levels of AST and GGT are correlated with early bile drainage.关键词
胆道闭锁/外科手术/手术后并发症/胆管炎/治疗结果/影响因素分析Key words
Biliary Atresia/Surgical Procedures,Operative/Postoperative Complications/Cholangi-tis/Treatment Outcome/Root Cause Analysis引用本文复制引用
李斯锦,曾纪晓,徐晓钢,兰梦龙,陶波圆,梁子建,刘斐..胆道闭锁Kasai手术后未发生胆管炎患儿的近中期疗效及影响因素分析[J].临床小儿外科杂志,2025,24(1):30-34,5.基金项目
国家自然科学基金(82170528) （82170528）
广东省自然科学基金(2022A1515012254) （2022A1515012254）
广州市科技计划市校(院)联合资助项目(202201020612) （院）
广州地区临床特色技术项目(2023C-TS48) （2023C-TS48）
广州市科技计划市校(院)企联合资助项目(2024A03J1236) National Natural Science Foundation of China(82170528) （院）
Natural Science Foundation of Guangdong Province(2022A1515012254) （2022A1515012254）
Guangzhou Municipal Joint Sponsoring Project of Science &Technology Plan of Schools(Colleges)(202201020612) （Colleges）
Clinical Specialty Technique Project of Guangzhou Region(2023C-TS48) （2023C-TS48）
Guangzhou Municipal Joint Sponsoring Project of Science & Technology Plan of School(College)Enterprises(2024A03J1236) （College）
