术前PTBD治疗对联合半肝切除的_省略_门部胆管癌根治术的安全性及有效性_李会星.pdfVIP

解放军医学院学报 Acad J Chin PLA Med Sch Sep 2014，35（9） 术前PTBD 治疗对联合半肝切除的肝门部胆管癌根治术的安全性及 有效性 李会星，史宪杰，万　涛，吕少诚，刘同友，张雯雯，徐明月，周桂华 解放军总医院 肝胆外科，北京　100853 摘要 ：目的 探讨对于拟行联合半肝切除治疗的肝门部胆管癌患者，术前行 PTBD 治疗的有效性及安全性。方法 回顾性分 析 2013 年 1 月 - 2013 年 12 月我院 112 例行联合半肝切除的肝门部胆管癌根治术的患者资料，总结分析其术前状态、手术 2 情况及术后并发症发生情况。结果 术中留取胆汁培养细菌阳性率差异无统计学意义 ( χ =0.054，P =0.816)。PTBD 组术前 TB 为 (107.1±29.6) μmol/L，NPTBD 组术前 TB(135.6±85.2) μmol/L，差异有统计学意义 (t =2.13，P =0.035)。PTBD 组术后 2 胆漏发生率较 NPTBD 组低，差异有统计学意义 ( χ =4.952，P=0.026)。PTBD 组切口感染、肝功不全等并发症发生率虽较 NPTBD 组低，但差异不具有统计学意义 (P ＞ 0.05)。结论 PTBD 作为一种安全、有效地减黄手段，可明显改善患者术前肝 功及全身营养状态，可大大降低术后胆漏发生率。 关键词 ：梗阻性黄疸 ；PTBD 治疗 ；肝门部胆管癌 ；半肝切除 中图分类号 ：R 735.7　文献标识码 ：A　文章编号 ：140123　DOI ：　　　 2014-04-28 09:16 /kcms/detail/11.3275.R0916.002.html 网络出版时间： 　　　　 网络出版地址 ：　　　　 Safety and effectiveness of preoperative PTBD therapy for radical resection of hilar cholangiocarcinoma combined with hemihepatectomy LI Hui-xing, SHI Xian-j ie, WAN Tao, LYU Shao-cheng, LIU Tong-you, ZHANG Wen-wen, XU Ming-yue, ZHOU Gui-hua Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beij ing 100853, China Corresponding author: SHI Xian-j ie. Email: shixianj ie30 1@126.com Abstract: Objective To investigate the safety and effectiveness of preoperative PTBD therapy for radical resection of hilar cholangiocarcinoma combined with hepatectomy. Methods Clinical data about 112 patients who underwent radical resection of hilar cholangiocarcinoma combined with hemihepatectomy admitted to our hospital from January 20 13 to December 20 13 were retrospectively analyzed. Then their preoperative condition, operation status and postoperative complications were summarized and analyzed. Results No statistically significant was found in positive rate of bacteria through