CAJ | 학술논문

目的探讨Kasai's术后胆管炎对胆道闭锁(BA)长期牛存的影响.方法通过对92例BA行Kasai's术时的手术年龄、术式和术后胆管炎发生等临床资料进行收集和分析,特别是重点分析早期胆管炎对患儿的影响.结果对1989年3月至1997年3月共92例BA行Kasai's术,手术年龄30～137 d.其中男55例,女37例.失访3例,死亡66例,存活23例巾男14例,女9例,存活患儿年龄最大者现已满19岁.92例中,在出生后60 d内手术25例,现存活5例;61～90 d手术53例.现存活15例.91 d以上手术14例,现存活3例.本组发生早期胆管炎58例,现仍存活7例.19例因肝门部胆管梗阻再次手术,现存活4例.结论 ①胆管炎的处理是BA治疗过程中最困难的一环.胆管炎是BA术后最常见又是最难处理的并发症;②防止早期胆管炎的发生是手术成功的关键,早期胆管炎的危害大.在适宜的年龄进行Kasai's术时,有无胆管炎发生与生存率关系更密切;③对因胆管炎引起的肝门部胆管梗阻应积极治疗;④早期胆管炎不但影响手术后的牛存率,还对远期生活质量有影响.
목적 탐토Kasai's술후담관염대담도폐쇄(BA)장기우존적영향.방법 통과대92례BA행Kasai's술시적수술년령、술식화술후담관염발생등림상자료진행수집화분석,특별시중점분석조기담관염대환인적영향.결과 대1989년3월지1997년3월공92례BA행Kasai's술,수술년령30～137 d.기중남55례,녀37례.실방3례,사망66례,존활23례건남14례,녀9례,존활환인년령최대자현이만19세.92례중,재출생후60 d내수술25례,현존활5례;61～90 d수술53례.현존활15례.91 d이상수술14례,현존활3례.본조발생조기담관염58례,현잉존활7례.19례인간문부담관경조재차수술,현존활4례.결론 ①담관염적처리시BA치료과정중최곤난적일배.담관염시BA술후최상견우시최난처리적병발증;②방지조기담관염적발생시수술성공적관건,조기담관염적위해대.재괄의적년령진행Kasai's술시,유무담관염발생여생존솔관계경밀절;③대인담관염인기적간문부담관경조응적겁치료;④조기담관염불단영향수술후적우존솔,환대원기생활질량유영향.
Objective To evaluate the effects of cholangitis after hepatic portoenterostomy for biliary atresia on the long term survival.Methods 92 patients with biliary atresia admhted into the First Affiliated Hospital of Sun Yat-Sen University in-patients between March 1 989 tO March 1997 underwent Kasai procedure were reviewed.The clinical data including the age.operation methods and the post-operative cholangitis,were analyzed.Results The patients' age ranged from 30 days to 137 days.There were 55 boys and 37 girls.The oldest patient was 19 years old.Currently,14 boys and 9 girls are still alive.This includes 5 out of 25 patients younger than 60 days.1 5 out of 53 patients be-tween 61 days and 90 days,3 out of 14 patients older than 91 days at the time of operation respective-ly.Seven OUt of 58 patients with early cbolangitis are still alive.Four out of 19 patients survived after re-operation.Conclusions Cbolangitis affects long term survival.Active treatment iS required for bile duct obstruction secondary to cholangits.