中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
20期
51-54
,共4页
常刚%薛栋%张晓燕%巩曰红%姜在波
常剛%薛棟%張曉燕%鞏曰紅%薑在波
상강%설동%장효연%공왈홍%강재파
黄疸,阻塞性%危险因素%引流术%预后
黃疸,阻塞性%危險因素%引流術%預後
황달,조새성%위험인소%인류술%예후
Jaundice,obstructive%Risk factors%Drainage%Prognosis
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(OR=3.729,95％ CI 1.332 ～ 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.
目的 探討低位噁性梗阻性黃疸應用介入引流治療的預後相關危險因素.方法 迴顧性分析2010年1月至2013年6月接受經皮介入引流治療的142例低位噁性梗阻性黃疸患者的臨床資料,以性彆、年齡、腫瘤類型、術前梗阻時間、術前感染、引流方式、肝功能Child-Pugh評分、血清總膽紅素、白蛋白、血清肌酐、術後膽紅素下降程度以及術後是否行抗腫瘤治療作為研究參數,評估影響其預後的相關危險因素.結果 單因素分析結果顯示,術前感染(P=0.006)、肝功能Child-Pugh評分(P=0.004)、血清肌酐(P=0.043)、血清總膽紅素下降程度(P=0.001)及術後是否行抗腫瘤治療(P=0.015)是影響低位噁性梗阻性黃疸介入引流治療患者生存期的相關因素;多因素Logistic迴歸分析顯示,術前感染(OR=3.729,95％ CI 1.332 ～ 6.363,P=0.040)、肝功能Child-Pugh評分≥10分(OR=0.513,95％CI0.375 ～ 1.276,P=0.018)及術後抗腫瘤治療(OR=0.668,95％CI0.210 ～ 2.026,P=0.038)是影響低位噁性梗阻性黃疸介入引流治療患者生存期的危險因素.結論 在對低位噁性梗阻性黃疸介入引流治療時,術前感染、肝功能Child-Pugh評分及術後是否行抗腫瘤治療可能是影響患者生存期的相關因素,對評估該類患者的預後有重要的參攷意義.
목적 탐토저위악성경조성황달응용개입인류치료적예후상관위험인소.방법 회고성분석2010년1월지2013년6월접수경피개입인류치료적142례저위악성경조성황달환자적림상자료,이성별、년령、종류류형、술전경조시간、술전감염、인류방식、간공능Child-Pugh평분、혈청총담홍소、백단백、혈청기항、술후담홍소하강정도이급술후시부행항종류치료작위연구삼수,평고영향기예후적상관위험인소.결과 단인소분석결과현시,술전감염(P=0.006)、간공능Child-Pugh평분(P=0.004)、혈청기항(P=0.043)、혈청총담홍소하강정도(P=0.001)급술후시부행항종류치료(P=0.015)시영향저위악성경조성황달개입인류치료환자생존기적상관인소;다인소Logistic회귀분석현시,술전감염(OR=3.729,95％ CI 1.332 ～ 6.363,P=0.040)、간공능Child-Pugh평분≥10분(OR=0.513,95％CI0.375 ～ 1.276,P=0.018)급술후항종류치료(OR=0.668,95％CI0.210 ～ 2.026,P=0.038)시영향저위악성경조성황달개입인류치료환자생존기적위험인소.결론 재대저위악성경조성황달개입인류치료시,술전감염、간공능Child-Pugh평분급술후시부행항종류치료가능시영향환자생존기적상관인소,대평고해류환자적예후유중요적삼고의의.
Objective To explore the prognostic risk factors of low level malignant obstructive jaundice treated with transhapetic biliary drainage.Methods The clinical data of 142 patients with low level malignant obstructive jaundice received percutaneous transhapetic 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 ≥ 10 scores (OR =0.513,95％ CI 0.375-1.276,P =0.018) and postoperative antineoplastic therapy (OR =0.668,95％ CI 0.210-2.026,P =0.038) were the related factors for survival time.Conclusion 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.
