摘要
目的观察低位恶性梗阻性黄疸行胰十二指肠切除术术前减黄对疗效和并发症发生率的影响。方法收集我院2017年1~12月78例低位恶性梗阻性黄疸患者资料,均行胰十二指肠切除术,根据术前是否减黄分为两组,36例术前减黄治疗为减黄组,42例未行减黄治疗为对照组,观察减黄组减黄前后总胆红素(TB)水平,比较两组围术期相关指标及术后并发症发生率和死亡率。结果减黄组根治术前TB水平为(209.62±22.96)μmol/L,明显低于减黄前的(311.07±39.76)μmol/L,且低于对照组根治术前的(297.83±42.69)μmol/L,差异均有统计学意义(P<0.05)。减黄组术前治疗时间和总时间较对照组长,异体红细胞输注量少于对照组,差异有统计学意义(P<0.05)。两组平均手术时间、平均输血量、术后住院时间差异无统计学意义(P>0.05)。减黄组并发症发生率为61.11%,死亡率为0.00%,对照组为66.67%和2.38%,差异无统计学意义(P>0.05)。结论低位恶性梗阻性黄疸行胰十二指肠切除术术前减黄可降低总胆红素水平,对患者预后无明显影响。
Objective To observe the effect and incidence of complications of preoperative biliary drainage before pancreatoduodenectomy for low malignant obstructive jaundice.Methods The data of 78 patients with lower malignant obstructive jaundice who were treated from January to December 2017 in our hospital were collected.All the patients were treated with pancreatoduodenectomy and divided into two groups preoperatively according to whether preoperative biliary drainage was conducted or not.Among them,36 patients who were given preoperative biliary drainage were taken as biliary drainage group;while,42 case who were not given preoperative biliary drainage were taken as control group.The total bilirubin（TB） before and after preoperative biliary drainage of biliary drainage group was observed.The perioperative indicators,postoperative morbidity and mortality were compared between the two groups.Results The TB level of biliary drainage group before radical resection was（209.62±22.96） μmol/L,which was significantly lower than that before biliary drainage（[311.07±39.76] μmol/L） and that of the control group（[297.83±42.69] μmol/L） before radical resection,both with statistically significant difference（P〈0.05）.The preoperative treatment duration and total treatment time of biliary drainage group were longer than those of control groups;and the allogenic erythrocyte infusion volume of biliary drainage group was less than that of control group,with statistically significant difference（P〈0.05）.There was no statistically significant difference in the mean operation time,mean blood transfusion volume and postoperative hospital stay between the two groups（P〉0.05）.The incidence of complications and mortality rate of biliary drainage group were61.11% and 0.00% versus control group′ s 66.67% and 2.38%,respectively,without statistically significant difference（P〉0.05）.Conclusion Application of preoperative biliary drainage before pancreatoduodenectomy for low malignant obstructive jaundice can reduce the level of total bilirubin,but has no significant effect on the prognosis of patients.
作者
许马川
谢伟
冯石坚
何国筛
陈晚妹
XU Ma-chuan;XIE Wei;FENG Shi-jian;HE Guo-shai;CHEN Wan-mei(Second Department of Surgery,People＇s Hospital of Yangjiang City,Guangdong Province,Yangjiang 529500,China)
出处
《中国当代医药》
2018年第15期19-21,25,共4页
China Modern Medicine
基金
广东省阳江市医疗卫生类科技计划项目(社发[2017]09)
关键词
低位恶性梗阻性黄疸
胰十二指肠切除术
减黄
疗效
并发症
Low malignant obstructive jaundice
Pancreatoduodenectomy
Biliary drainage
Efficacy
Complications
