介入治疗恶性梗阻性黄疸的预后因素分析

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1、摘要：目的探讨经皮肝穿刺胆道引流术及胆管金属支架植入术治疗恶性梗阻性黄疸预后的影响因素。方法回顾性采集102例行经皮肝穿刺胆道引流术和胆道支架放置术患者的临床和病理资料，随访1年，Cox比例风险回归进行生存分析。结果①中位生存时间6.89±2.58月，6月和12月生存率分别是54.14%和27.81%;②单因素分析：并发症、梗阻段、瘤体体积、肿瘤分期、白细胞总数等是影响恶性梗阻性黄疽姑息术预后的主要因素（P<0.05），性别、年龄、总胆红素、谷草转氨酶、谷丙转氨酶、碱性磷酸酶、Y-谷氨酸转肽酶、血红蛋白含量等因素与恶性梗阻性黄疽姑息术预后无关（P〉0.05）;③多因

2、素分析：并发症（RR=1.874）、梗阻段（RR=2.140）、瘤体体积（RR=1.051）和白细胞总数（RR=1.023）肿瘤分期（RR=2.296）是影响预后的独立因素。结论并发症、梗阻段、瘤体体积和白细胞总数肿瘤分期是影响预后的独立因素。关键词：恶性梗阻性黄疽;金属支架;生存分析;预AnalysisofthePrognosticFactorsforPatientswithMalignantBiliaryObstructionafterInterventionalTherapyZHANGJun-xi1，LIFa-zhong2,CHAIJian1，MAYing-h

3、uil,DONGWeil(1•HenanProvincialResearchInstituteforPopulationandFamilyPlanning,Zhengzhou450002，Henan，China;2.DepartmentofInterventionalRadiology,LuoyangCityCentralHospital,Luoyang471000,Henan,China)Abstract：ObjectiveToexploretheprognosticfactorsofmalignantbiliaryobstructionpatientsafter

4、percutaneoustranshepaticcholangialdrainage(PTCD)orbiliarymetalstentimplantation.MethodsTheclinicalandpathologicaland1yearsoffollow-updatafor102patientswithmalignantbiliaryobstructionwhounderwentPTCDorbiliarymetalstentimplantationwereretrospectivelycollected.Theprognosticfactorsofmalign

5、antbiliaryobstructionpatientsafterinterventionaltherapywereanalyzedbyCoxproportionalhazardsregressionmodel.Resultsl.Themediansurvivaltimewas6.89±2.58months，andthe6moand12mocumulativesurvivalrateswere54.14%and27.81%.2.Univariateanalysisshowedthatcomplication,obstruct,tumorsize,tumorstag

6、eandthetotalnumberofwhitebloodcellswerethemainprognosisfactorsinthesepatients(P<0.05).However,gender，age，totalbilirubin,aspartateaminotransferase,alanineaminotransferasem,Alkalinephosphatase,gammaglutamyltranspeptidaseandhemoglobincontentwerenotsignificantpredictorsoftheprognosisinthes

7、epatients(P〉0.05).3.Multivariateanalysisshowedthatcomplication(RR二1.874)，obstruct(RR=2.140)，tumorsize(RR=1.051)，thetotalnumberofwhitebloodcells(RR=1.023)andtumorstage(RR=2.296)wereindependentprognosticfactorsinthesepatients.ConclusionComplication,obstruct，tumorsize，thetotalnumberofwh