CAJ | 학술논문

目的探讨经皮肝穿刺胆道引流术及胆管金属支架植入术治疗恶性梗阻性黄疸预后的影响因素。方法回顾性采集102例行经皮肝穿刺胆道引流术和胆道支架放置术患者的临床和病理资料，随访1年，Cox比例风险回归进行生存分析。结果①中位生存时间6.89依2.58月，6月和12月生存率分别是54.14%和27.81%；②单因素分析：并发症、梗阻段、瘤体体积、肿瘤分期、白细胞总数等是影响恶性梗阻性黄疸姑息术预后的主要因素(约0.05)，性别、年龄、总胆红素、谷草转氨酶、谷丙转氨酶、碱性磷酸酶、γ-谷氨酸转肽酶、血红蛋白含量等因素与恶性梗阻性黄疸姑息术预后无关(跃0.05)；③多因素分析：并发症(RR=1.874)、梗阻段(RR=2.140)、瘤体体积(RR=1.051)和白细胞总数(RR=1.023)肿瘤分期(RR=2.296)是影响预后的独立因素。结论并发症、梗阻段、瘤体体积和白细胞总数肿瘤分期是影响预后的独立因素。
목적탐토경피간천자담도인류술급담관금속지가식입술치료악성경조성황달예후적영향인소。방법회고성채집102례행경피간천자담도인류술화담도지가방치술환자적림상화병리자료，수방1년，Cox비례풍험회귀진행생존분석。결과①중위생존시간6.89의2.58월，6월화12월생존솔분별시54.14%화27.81%；②단인소분석：병발증、경조단、류체체적、종류분기、백세포총수등시영향악성경조성황달고식술예후적주요인소(약0.05)，성별、년령、총담홍소、곡초전안매、곡병전안매、감성린산매、γ-곡안산전태매、혈홍단백함량등인소여악성경조성황달고식술예후무관(약0.05)；③다인소분석：병발증(RR=1.874)、경조단(RR=2.140)、류체체적(RR=1.051)화백세포총수(RR=1.023)종류분기(RR=2.296)시영향예후적독립인소。결론병발증、경조단、류체체적화백세포총수종류분기시영향예후적독립인소。
Objective To explore the prognostic factors of malignant biliary obstruction patients after percutaneous transhepatic cholangial drainage (PTCD)or biliary metal stent implantation. Methods The clinical and pathological and 1 years of fol ow-up data for 102 patients with malignant biliary obstruction who underwent PTCD or biliary metal stent implantation were retrospectively col ected. The prognostic factors of malignant biliary obstruction patients after interventional therapy were analyzed by Cox proportional hazards regression model. Results 1.The median survival time was 6.89 ±2.58 months, and the 6mo and 12mo cumulative survival rates were 54.14% and 27.81%. 2. Univariate analysis showed that complication, obstruct, tumor size, tumor stage and the total number of white blood cells were the main prognosis factors in these patients ( <0.05). However, gender, age, total bilirubin, aspartate aminotransferase, alanine aminotransferasem, Alkaline phosphatase, gamma glutamyl transpeptidase and hemoglobin content were not significant predictors of the prognosis in these patients ( >0.05). 3. Multivariate analysis showed that complication (RR=1.874), obstruct (RR=2.140), tumor size (RR=1.051), the total number of white blood cells (RR=1.023) and tumor stage (RR=2.296) were independent prognostic factors in these patients. Conclusion Complication, obstruct, tumor size, the total number of white blood cells and tumor stage are independent risk factors, and can be helpful for prognosis of malignant biliary obstruction patients who received interventional therapy.