影响恶性梗阻性黄疸降黄疗效的相关因素分析

The correlative factors of palliation efficacy in malignant obstructive jaundice

目的探索影响恶性梗阻性黄疸降黄疗效的相关因素。方法回顾性分析2014年3月至2017年12月期间上海交通大学医学院附属第九人民医院普外科收治的107例恶性梗阻性黄疸患者的临床资料,分析恶性梗阻性黄疸患者术后1周及1个月降黄疗效的影响因素。结果多因素分析结果显示:梗阻部位和术前白蛋白水平是患者术后1周降黄疗效的影响因素(P<0.05),肝门部梗阻及低白蛋白水平的患者术后1周的降黄疗效欠佳;梗阻部位、术前白蛋白及术前总胆红素水平是影响患者术后1个月的降黄疗效的独立影响因素(P<0.05),肝门部梗阻、术前低白蛋白水平及术前高总胆红素水平的患者术后1个月的降黄疗效欠佳。结论梗阻部位、术前白蛋白水平及术前总胆红素水平是影响降黄疗效的独立相关因素,对预后评估具有重要作用。

Objective To explore the influencing factors of palliation efficacy in malignant obstructive jaundice. Methods Clinical data of 107 patients with malignant obstructive jaundice who treated in Department of General Surgery, Shanghai Ninth People＇s Hospital, Shanghai Jiao Tong University School of Medicine, from March 2014 to December 2017, were retrospectively collected to analyze the influencing factors of palliation efficacy in 1 week and 1 month after operation. Results Multivariate analysis results showed that, hilar obstruction and preoperative albumin level were influencing factors of palliation efficacy in 1 week after operation （P〈0.05）, patients with hepatic portal obstruction, and low preoperative albumin level had poor effect; hilar obstruction, preoperative albumin and total bilirubin level were influencing factors of palliation efficacy in 1 month after operation （P〈0.05）, patients with hepatic portal obstruction, low preoperative albumin level, and high total bilirubin level had poor effect. Conclusions The obstruction location, preoperative albumin level, and total bilirubin level are the independent influencing factors of palliation efficacy which played an important role in prognostic assessment.