梗阻性黄疸术前血清胆红素水平与术后并发症关系的探讨

The preoperative serum bilirubin level of obstructive jaundice and postoperative complications

目的总结引起梗阻性黄疸术后并发症的主要危险因素,探讨术前血清胆红素水平与术后并发症的关系。方法回顾性分析2000年至2004年施行手术治疗的312例梗阻性黄疸病人,对不同血清胆红素水平的病人进行比较,分析术后并发症的发生率、死亡率与术前血清胆红素水平的关系。结果术前血清胆红素≥342μmol/L的病人中肺部感染、肝功能不全、肾功能不全、切口延迟愈合、吻合口瘘、腹腔脓肿、胃肠道出血等并发症的发生率及死亡率明显增高。结论血清胆红素是预测梗阻性黄疸手术危险性的重要指标之一;梗阻性黄疸术前血清胆红素水平超过342μmol/L时术后并发症的发生率及死亡率明显增高;对梗阻性黄疸病人应尽早解除胆道梗阻。

Objective To summarize the major risk factors of postoper-ative complications of obstrctive jaundice, to investigate the relation-ship between the preoperative serum bilirubin level and postoperative complications.Methods Retrospective analysis was used on 312 patients with obstructive jaundice admitted and received surgery treatment from 2000 to 2004, to evaluate the incidence rate,death rate of postoperative complications towards different horizontal of serum bilirubin patients.Results Pulmonary infection, hepatic inadequacy, incisal opening late healed,stoma fistulae,intra-abdominal abscess,gastrointestinal bleeding and others postoperative complications in patients with serum b＇dirubin I〉 342/maol/L to increased obviously. Conclusion The preoperative serum bilirubin is one of the most important factors to calculate the surgical risk of obstructive jaundice. Postoperative complications incidences and mo-rtality in patients with serum bilinubin≥342μnol/L was increased obvi-ously;patients with obstructive jaundice should relief obstruction of biliary tract as early as possible.