影响非手术治疗肝门部胆管癌预后因素分析

ANALYSIS OF FACTORS LNFLUENCING PROGNOSIS OF PATIENTS UNDERWENT HILAR CARCINOMA WOTHOUT RESECTION

目的 分析影响非手术肝门部胆管癌预后因素。方法 对我院2002年～2007年期间有明显手术禁忌的43位患者进行研究。本组患者中接受内镜支架引流者27例，接受经皮经肝穿刺引流患者16例。选择可能影响非手术肝门部胆管癌的临床病理因素，并通过Kaplan—Meier曲线进行分析。结果 全组非手术肝门部胆管癌患者平均生存期为289天。单因素分析提示，患者初始胆红素水平影响肝门部胆管癌的预后。Kaplan-Meier曲线分析提示，初始胆红素〉171umol／L的生存期少于初始胆红素〈171umol／L的患者。结论 影响非手术肝门部胆管癌患者预后的较重要的因素是患者初始胆红素水平，而ERBD和PTBD引流对患者生存期影响无明显差异。

Objective To analysis the factors influencing the prognosis of patients underwent hilar carcinoma without resection. Methods The clinical dates of 43 patients receiving palliative endoscopic transpapillary （ n = 27 ） or percutaneous transhepatic biliary drainage（ n = 16） in our hospital from 2002 to 2007 were collected retrospectively and clinicopathologic factors that might influence survival were analyzed, a survival factor analysis were performed through Kaplan-Meier cure and log-rank test. Results All of the 43 patients were with an average of 289 days. The single factor analysis showed that the major significant factor influencing survival of these patients was initial bilirubin level（ P 〈 0. 05 ）. Initial bilirubin level was found to be the statistically significant factor influencing survival by Kaplan-Meier cure. Conclusion The most important prognostic factor for bile duct carcinoma without resection was initial bilirubin level ,the type of biliary-drainage（ ERBD or PTBD ） had no significant beneficial effect on the mean of survival time.