CAJ | 학술논문

目的：研究术前减黄对65例行胰十二指肠切除术（PD）的低位胆道恶性梗阻性黄疸患者的影响。方法按术前是否经减黄处理将65例低位胆道恶性梗阻性黄疸患者分为减黄组与未减黄组，减黄组共35例，未减黄组共30例。减黄组患者经减黄处理后进行胰十二指肠切除手术，未减黄组患者在检查完毕后直接进行手术。结果减黄组 TB 水平组内比较、两组术前 TB 组间比较差异均有统计学意义（P ＜0.05），但两组患者入院时的 TB 比较无明显差异（P ＞0.05）；两组患者的手术时间、出血量、血浆输注量及术后住院时间的组间对比无明显差异（P ＞0.05），但两组的 RBC 输注量组间比较差异有统计学意义（P ＜0.01）；行胰十二指肠切除手术后，减黄组与未减黄组的并发症发生情况比较无显著性差异（P ＞0.05）。结论术前减黄能有效降低低位胆道恶性梗阻性黄疸患者的总胆红素水平，但是术前减黄并不能减少患者行 PD 手术后并发症的发生。
목적：연구술전감황대65례행이십이지장절제술（PD）적저위담도악성경조성황달환자적영향。방법안술전시부경감황처리장65례저위담도악성경조성황달환자분위감황조여미감황조，감황조공35례，미감황조공30례。감황조환자경감황처리후진행이십이지장절제수술，미감황조환자재검사완필후직접진행수술。결과감황조 TB 수평조내비교、량조술전 TB 조간비교차이균유통계학의의（P ＜0.05），단량조환자입원시적 TB 비교무명현차이（P ＞0.05）；량조환자적수술시간、출혈량、혈장수주량급술후주원시간적조간대비무명현차이（P ＞0.05），단량조적 RBC 수주량조간비교차이유통계학의의（P ＜0.01）；행이십이지장절제수술후，감황조여미감황조적병발증발생정황비교무현저성차이（P ＞0.05）。결론술전감황능유효강저저위담도악성경조성황달환자적총담홍소수평，단시술전감황병불능감소환자행 PD 수술후병발증적발생。
Objective To study the effect of preoperative biliary drainage (PBD) of pancreaticoduodenectomy in 65 patients with malignant obstructive jaundice of the lower bile duct. Methods 65 patients with malignant obstructive jaundice of the lower bile duct were divided into PBD group and non-PBD group according to preoperative biliary drainage or not, with 35 cases in PBD group and 30 cases in non-PBD group. Patients in PBD group were treated with PBD of pancreaticoduodenectomy, while patients in non-PBD group were treated with direct surgery after inspection. Results The preoperative TB levels intragroup and which between the two groups all had comparability and statically significant(P < 0.05), but which on admission had non statically significant(P >0.05). The operation time, blood loss, plasma transfusion, and postoperative hospital stay of patients between the two groups had non statically significant (P > 0.05), while the RBC transfusion between the two groups had statically significant(P < 0.01). The occurrence condition of complication after pancreaticoduodenectomy between the two groups had non statically significant (P > 0.05). Conclusion PBD could effectively reduce the serum total bilirubin of patients with malignant obstructive jaundice of the lower bile duct, but couldn’t reduce the complication after pancreaticoduodenectomy.