温阳活血利湿方联合熊去氧胆酸对小儿胆道闭锁Kasai术后并发症及预后的影响

Effect of Warming Yang and Activating Blood Circulation for Promoting Dieresis Method Combined with Ursodeoxycholic Acid on Postoperative Complications and Prognosis of Children with Biliary Atresia after Kasai Operation

目的研究温阳活血利湿法联合熊去氧胆酸应用于小儿胆道闭锁(BA)Kasai术后的效果。方法选取2020年1月—2021年1月镇平县人民医院小儿BA患者98例,按照随机数字表法分为对照组、观察组,各49例。2组均行Kasai术,对照组采用熊去氧胆酸,观察组采用温阳活血利湿法联合熊去氧胆酸。比较2组治疗4周后疗效、治疗前、治疗4周后肝功能、血清胆红素水平,并对比治疗期间并发症(胆管炎发生次数)及半年内预后情况。结果观察组总有效率高于对照组(P<0.05);治疗4周后观察组ALT、AST、TBIL水平低于对照组(P<0.05);观察组胆管炎发生次数少于对照组(P<0.05);2组经临床积极治疗后,均得到缓解或治愈,半年内无死亡病例发生,预后良好。结论温阳活血利湿法联合熊去氧胆酸应用于小儿BA Kasai术后疗效显著,能改善肝功能,调节血清胆红素水平,降低并发症发生率,预后良好。

Objective To study the effect of warming yang and activating blood circulation for promoting dieresis method combined with ursodeoxycholic acid on children with biliary atresia(BA)after Kasai operation.Methods Ninety-eight children with BA in Zhenping County People’s Hospital from January 2020 to January 2021 were selected and randomly divided into control group and observation group,with forty-nine cases in each group.The control group was treated with ursodeoxycholic acid,and the observation group was treated with warming yang and activating blood circulation for promoting dieresis method combined with ursodeoxycholic acid.The curative effect,liver function,serum bilirubin before and after 4 weeks of treatment and the complications(frequency of cholangitis)and prognosis during treatment were compared between the two groups.Results The total effective rate of the observation group was higher than the control group(P<0.05).After 4 weeks of treatment,the levels of ALT,AST,TBIL in the observation group were lower than those in the control group(P<0.05).The incidence of cholangitis in the observation group was less than that in the control group(P<0.05).After active clinical treatment,all the complications were relieved or cured,no death occurred and the prognosis was good.Conclusion Warming yang and activating blood circulation for promoting dieresis method combined with ursodeoxycholic acid can improve liver function,regulate serum bilirubin level,reduce the incidence of complications and have a good prognosis.