CAJ | 학술논문

目的：探讨经皮肝胆管引流术（PTBD）或经皮肝胆管内支架引流术（PTIBS）治疗恶性梗阻性黄疸术后并发胆道感染的相关因素。方法共157例恶性梗阻性黄疸患者首次采用 PTBD 或 PTIBS 介入治疗，分类对比临床发病特征、手术方式和术后观察资料。结果共23例恶性梗阻性黄疸介入术后并发胆道感染，发生率14.6％。多因素分析显示，术前胆道感染病史、术前黄疸天数、低位梗阻、不全梗阻、支架累及 Oddis括约肌、术后胆汁引流不畅是造成术后胆道感染发生的相关因素（P＜0．05）。结论术前详细了解病史、依据梗阻平面和程度合理选择介入治疗方法、加强术后观察，能够降低恶性梗阻性黄疸介入术后胆道感染的发生率。
목적：탐토경피간담관인류술（PTBD）혹경피간담관내지가인류술（PTIBS）치료악성경조성황달술후병발담도감염적상관인소。방법공157례악성경조성황달환자수차채용 PTBD 혹 PTIBS 개입치료，분류대비림상발병특정、수술방식화술후관찰자료。결과공23례악성경조성황달개입술후병발담도감염，발생솔14.6％。다인소분석현시，술전담도감염병사、술전황달천수、저위경조、불전경조、지가루급 Oddis괄약기、술후담즙인류불창시조성술후담도감염발생적상관인소（P＜0．05）。결론술전상세료해병사、의거경조평면화정도합리선택개입치료방법、가강술후관찰，능구강저악성경조성황달개입술후담도감염적발생솔。
Objective Toidentifyfactorsrelatedtotheoccurrenceofbiliaryinfectionasacomplication after percutaneous transhepatic biliary drainage (PTBD)and percutaneous transhepatic insertion of biliary stent(PTIBS)inpatientswithmalignantobstructivejaundice.Methods Onehundredandfifty-seven patients due to solid malignancies underwent PTBD or PTIBS in our institution.Baseline characteristics, procedurecomplications,andoutcomeswereretrospectivelycollected.Results Therewere23(14.6%) cases of immediate biliary infection following PTBD or PTIBS.By multivariate analysis,preoperative biliary infection history,the number of days of preoperative jaundice,lower obstruction,incomplete obstruction, stent over Odiss’s sphincter,and impaired bile drainage are the relative factors with biliary infection occurred afterinterventionaltherapy(P<0.05).Conclusion Tounderstandthedetailofpreoperativehistory,to choose interventional therapy according to the plane and the degree of obstruction, and to reinforce postoperative observation can reduce the incidence rate of biliary infection with the malignant obstructive jaundice after interventional treatment.