阻塞性黄疸经皮经肝胆管造影下胆道活检敏感性的影响因素分析

The factors influencing biopsy sensitivity of percutaneous transhepatic cholangiobiopsy for obstructive jaundice

目的探索影响阻塞性黄疸经皮经肝胆管造影(PTC)下胆道活检敏感性的影响因素。方法对2001年4月至2004年3月间81例 PTC 胆道活检患者进行研究。选择20个可能对 PTC 胆道活检敏感性产生影响的非重复性特征性因素,应用 Logistic 回归模型对 PTC 胆道活检后患者进行多因素分析。结果 PTC 胆道活检敏感性为85.19%。单因素分析得出活检钳类型、肝内二级胆管的扩张程度、阻塞段长度、球囊扩张前后活检和胆管壁浸润对 PTC 胆道活检敏感性有影响(P<0.05)。Logis-tic 回归模型多因素分析表明,阻塞段长度、球囊扩张前后活检和胆管壁浸润是影响 PTC 胆道活检的主要因素。结论球囊扩张前后活检、阻塞长度和胆管浸润是影响 PTC 胆管活检敏感性的最重要因素。

Objective To investigate the factors influencing biopsy sensitivity under percutaneous transhepatic cholangiobiopsy in patients with obstructive jaundice. Methods Eighty six patients with obstructive jaundice performed with percutaneous transhepatic cholangiobiopsy were retrospectively analyzed and 18 parameters were selected for study. A multivariate analysis was conducted in these subjects with I.ogistic regression model. Results The biopsy sensitivity of percutaneous transhepatic cholangiobiopsy was 85. 19%. The univariate analysis showed that the significant influencing factors were types of biopsy forceps, degree of bile ducts dilation, length of obstructive segment, lesion invasion and balloon dilation （P〈0.05）. Length of obstructive segment, lesion invasion and balloon dilation were found to be the most important factors by multivariate analysis of Logistic regression model. Conclusions Biopsy after balloon dilation, length of obstructive segment and lesion invasion were the most important factors influencing the biopsy sensitivity of percutaneous transhepatic cholangiobiopsy in patients with obstructive jaundice.