中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
18期
2755-2757
,共3页
胆道闭锁%肝门空肠吻合术%治疗结果
膽道閉鎖%肝門空腸吻閤術%治療結果
담도폐쇄%간문공장문합술%치료결과
Biliary atresia%Hepaticojejunostomy%Treatment outcome
目的 探讨肝门空肠吻合术(Kasai术)对胆道闭锁的近中期疗效及其影响因素.方法 回顾性分析62例行Kasai术胆道闭锁患儿的临床资料.分析患儿黄疸消退率、2年自体肝存活率和影响预后的因素.结果 62例患儿术后黄疸消退率为58.1％,2年自体肝存活率为53.2％.其中Ⅰ、Ⅱ、Ⅲ型患儿黄疸消退率、2年存活率的差异均无统计学意义(χ2=1.91、0.76,均P＞0.05).60 d内手术的2年自体肝存活率明显高于61 ～90 d、90d后手术的(χ2=4.72,P＜0.05).感染巨细胞病毒以及术后并发胆管炎的患儿2年自体肝存活率分别为43.6％、39.5％,明显低于非感染感染巨细胞病毒以及未并发胆管炎患儿的69.6％、75.0％(χ2=3.92、7.46,均P＜0.05).结论 Kasai手术仍是治疗胆道闭锁的首选方法,患儿的疾病分型与Kasai术后近中期疗效没有明显关系,手术年龄则是影响预后的主要因素.因此,做到及早手术、加强抗病毒治疗以及术后防治胆管炎尤为重要.
目的 探討肝門空腸吻閤術(Kasai術)對膽道閉鎖的近中期療效及其影響因素.方法 迴顧性分析62例行Kasai術膽道閉鎖患兒的臨床資料.分析患兒黃疸消退率、2年自體肝存活率和影響預後的因素.結果 62例患兒術後黃疸消退率為58.1％,2年自體肝存活率為53.2％.其中Ⅰ、Ⅱ、Ⅲ型患兒黃疸消退率、2年存活率的差異均無統計學意義(χ2=1.91、0.76,均P＞0.05).60 d內手術的2年自體肝存活率明顯高于61 ～90 d、90d後手術的(χ2=4.72,P＜0.05).感染巨細胞病毒以及術後併髮膽管炎的患兒2年自體肝存活率分彆為43.6％、39.5％,明顯低于非感染感染巨細胞病毒以及未併髮膽管炎患兒的69.6％、75.0％(χ2=3.92、7.46,均P＜0.05).結論 Kasai手術仍是治療膽道閉鎖的首選方法,患兒的疾病分型與Kasai術後近中期療效沒有明顯關繫,手術年齡則是影響預後的主要因素.因此,做到及早手術、加彊抗病毒治療以及術後防治膽管炎尤為重要.
목적 탐토간문공장문합술(Kasai술)대담도폐쇄적근중기료효급기영향인소.방법 회고성분석62례행Kasai술담도폐쇄환인적림상자료.분석환인황달소퇴솔、2년자체간존활솔화영향예후적인소.결과 62례환인술후황달소퇴솔위58.1％,2년자체간존활솔위53.2％.기중Ⅰ、Ⅱ、Ⅲ형환인황달소퇴솔、2년존활솔적차이균무통계학의의(χ2=1.91、0.76,균P＞0.05).60 d내수술적2년자체간존활솔명현고우61 ～90 d、90d후수술적(χ2=4.72,P＜0.05).감염거세포병독이급술후병발담관염적환인2년자체간존활솔분별위43.6％、39.5％,명현저우비감염감염거세포병독이급미병발담관염환인적69.6％、75.0％(χ2=3.92、7.46,균P＜0.05).결론 Kasai수술잉시치료담도폐쇄적수선방법,환인적질병분형여Kasai술후근중기료효몰유명현관계,수술년령칙시영향예후적주요인소.인차,주도급조수술、가강항병독치료이급술후방치담관염우위중요.
Objective To explore the short-and mid-term curative effect and influence factors of hepaticojejunostomy(Kasai operation) for biliary atresia.Methods The clinical data of 66 children with biliary atresia treated with Kasai operation were analyzed retrospectively.The jaundice fading rate,2-year survival rate and influence factors of prognostic were analyzed.Results The jaundice fading rate of 62 cases was 58.1％ after Kasai operatiou.The patients also had a 2-year native liver survival rate of 53.2％.The jaundice fading rate,2-year survival rate of type Ⅰ,Ⅱ and Ⅲ had no significant differences (χ2 =1.91,0.76,all P ＞ 0.05).The 2-year survival rate of children underwent Kasai operation as younger than 60 days was higher rate than that of the children as 61 to 90 days and older than 90 days(χ2 =4.72,P ＜ 0.05).The 2-year survival rate of children with cytoinegalovirus infection and postoperative cholangitis were 43.6％,39.5％,respectively,which were lower than those of children without cytomegalovirus infection and postoperative cholangitis (69.6％.75.0％) (χ2 =3.92,7.46,all P ＜ 0.05).Conclusion Kasai operation is still the preferred method for the treatinent of biliary atresia.Type of the disease was not related with the short-and mid-term effects of Kasai operation.Age at operation was the main factor affecting the prognosis.Therefore,it is very important to make early surgery,enhance the anti-viral treatment and prevent postoperative cholangitis.
