手术年龄对胆道闭锁Kasai手术后预后影响的研究
- 摘要:
- 目的探讨胆道闭锁患儿接受Kasai手术时的年龄对预后的影响。方法回顾性分析2001年1月～2005年2月我院85例行Kasai手术的胆道闭锁患儿病例资料。按手术年龄分为<60d组32例,60～90d组40例,>90d组13例。至2007年2月,获随访且术后存活时间超过2年的患儿27例。结果<60d组中,56.25%的患儿术后1个月血清胆红素较术前下降三分之一;40.63%的患儿术后3个月血清胆红素降至正常;46.88%的患儿术后6个月血清胆红素降至正常。60～90d组中,术后1个月血清胆红素下降三分之一、术后3个月及6个月降至正常率分别为65%、37.5%和50%。>90d组患儿中则分别为46.15%、23.08%和23.08%。术后1个月、3个月血清胆红素下降率3组差异无统计学意义;>90d组患儿术后6个月黄疸消退率较其他两组降低,P<0.05。获随访的27例存活2年以上患儿中,<60d组、60～90d组和>90d组分别为15例、9例和3例,各占60%、32.14%和30%,P<0.05。结论胆道闭锁患儿早期手术(出生后1～3个月)血清胆红素下降快,黄疸消退率及2年以上存活率均明显高于晚期手术者;2年无黄疸生存预示长期生存和生活质量提高。
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备注/Memo
基金:上海市科委重点项目(项目号044119602);上海市卫生局百人计划项目(项目号97BR024)。;