肝门肠吻合术治疗胆道闭锁112例报告
董淳强;杨体泉;董昆;罗意革;陈超;刘强
【期刊名称】《中华小儿外科杂志》 【年(卷),期】2013(034)003
【摘要】Objective To summarize our experience on Kasai procedure (KP) for the treatment of biliary atresia (BA).Methods From January 2007 to December 2011,126 patients with type ⅢBA underwent KP at this center.After surgery,112 (89.7％) of them was followed up,and their clinical
data
were
retrospectively
analyzed
to
evaluate
the
outcome.Results The jaundice free was seen in 70 (62.5％) patients.According to the age at surgery,the patients were divided into 4 groups:≤60 d group,60～90 d group,90～120 d group,and ＞120 d group.The jaundice free rates of the 4 groups were statistically different (jaundice free rate 72.0％,80.5％,60.0％,and 19.0％,respectively,P＜0.05).The incidence of cholangitis was 30.4％ (34/112).The incidence of cholangitis in jaundice free patients was significantly lower than that of the patients with persistent jaundice (21.4％versus 45.2％,P＜0.05).The patients with the age at surgery ＞90 d (93.5％),or persistent jaundice (100％),or postoperative cholangitis (50％),had a higher incidence of hepatic fibrosis.The 1-year and 2-year survival rate with native liver was 64.9％ and 61.8％ respectively.Age at surgery,jaundice,severity of cholangitis and persistent hepatic fibrosis,were the predictive factors for
outcomes of surgery (P＜0.05).Conclusions The type Ⅲ BA patients who are younger than 90 days at surgery,jaundice free and less incidence cholangitis after surgery have longer survival time with native liver.%目的 评价肝门肠吻合术(Kasai手术)治疗胆道闭锁的效果并总结治疗经验.方法 对2007年1月至2011年12月集中收治并采用统一的治疗方案进行Kasai手术的Ⅲ型胆道闭锁病例进行回顾性分析.结果 进行Kasai手术的126例有112例(89.7％)获得完整随访.术后有70例黄疸清除,总黄疸清除率为62.5％,黄疸清除率在手术年龄≤60 d、60～90 d(包含90d)、90～120 d、＞120 d组分别为72.0％、80.5％、60.0％和19.0％,组间差异有统计学意义(P＜0.05).总胆管炎发生率为30.4％(34/112),黄疸清除组(15例)的胆管炎发生率(21.4％)低于未清除组(19例,45.2),组间差异有统计学意义(P＜0.05).术后68例(60.7％)出现持续肝纤维化,在各因素中分组中手术年龄＞90 d、黄疸未清除和胆管炎发作的病例,出现持续肝纤维化的比率较高(分别为93.5％,100％和50％),组间差异有统计学意义(P＜0.05).本组1年和2年自体肝生存率分别为64.9％和61.8％.单因素生存分析发现,患儿手术年龄、术后黄疸消退与否、胆管炎发作与否以及肝纤维化活动情况是影响自体肝生存的相关因素(P＜0.05).结论 术后黄疸清除和胆管炎发作与否以及自体肝生存时间是胆道闭锁Kasai手术的评价指标,手术年龄≤90d,术后黄疸清除和较少的胆管炎发作有利于术后自体肝生存. 【总页数】5页(180-184)
【关键词】胆道闭锁;吻合术,外科;存活率 【作者】董淳强;杨体泉;董昆;罗意革;陈超;刘强
【作者单位】530021 南宁,广西医科大学第一附属医院小儿外科
【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-pediatric-surgery_thesis/0201235719197.html 【相关文献】
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肝门肠吻合术治疗胆道闭锁112例报告
