| 摘要: |
| 目的:探讨综合用药管理对先天性胆道闭锁( CBA) 葛西手术( Kasai 术) 后早期并发症的影响。方法:回顾性分析2019
年11 月至2020 年12 月我院收治行Kasai 术CBA 患儿96 例,按不同治疗方法分为对照组和观察组各48 例。对照组于术后予
以退黄、利胆、营养支持及激素冲击(短期) 等基础治疗,观察组在对照组治疗基础上施行综合用药管理,主要为激素冲击( 长
期)及抗生素(预防性)使用,均持续治疗3 个月。比较两组患儿治疗后黄疸清除率,统计术后早期并发症及激素相关并发症,
随访至2022 年3 月,统计自体肝1 年及2 年生存率,并使用Kaplan-Meier 法绘制生存曲线。结果:观察组黄疸清除率高于对照
组(P<0. 05);两组患儿激素相关并发症发生率比较差异无统计学意义(P>0. 05);术后早期并发症中,观察组胆管炎发生率为
41. 67%,低于对照组的64. 58%(P<0. 05);随访截至2022 年3 月,随访时间4~31 个月,中位随访时间25 个月。经Log-Rank 检
验显示,两组患儿自体肝生存率比较差异无统计学意义(P>0. 05)。结论:CBA 患儿Kasai 术后采用综合用药管理,可提高黄疸
清除率,降低术后胆管炎发生率,激素相关并发症无明显增加,但并未延长自体肝1 年及2 年生存期。 |
| 关键词: 先天性胆道闭锁 葛西手术 综合用药管理 并发症 黄疸清除率 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.12.008 |
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| 基金项目: |
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| Effects of Different Intervention Methods on Early Postoperative Complications in Patients with Congenital Biliary Atresia Undergoing Kasai Surgery |
| Wang Juping, Pei Baofang |
| (Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China) |
| Abstract: |
| Objective: To probe into the effects of comprehensive drug management on early postoperative complications in patients with
congenital biliary atresia (CBA) undergoing Kasai surgery. Methods: Retrospective study was performed on 96 children with CBA
undergoing Kasai surgery in our hospital from Nov. 2019 to Dec. 2020. All patients were divided into the control group and observation
group according to different treatment methods, with 48 cases in each group. The control group was given basic treatment such as
jaundice clearance and gallbladder function improvement, nutritional support and hormone shock therapy (short-term) after surgery,
while the observation group received comprehensive drug management based on the treatment of the control group, mainly hormone shock
therapy (long-term) and antibiotics (prophylaxis), all of which lasted for 3 months. The jaundice clearance rate after treatment, early
postoperative complications and hormone-related complications of two groups were compared. Follow-up was performed until Mar. 2022.
The one-year and two-year survival rates of autologous liver were measured, and survival curves were plotted by using Kaplan-Meier
method. Results: The jaundice clearance rate in the observation group was higher than that in the control group (P<0. 05). There was
no significant difference in the incidence of hormone-related complications between two groups (P>0. 05). In the early postoperative
complications, the incidence of cholangitis in the observation group was 41. 67%, lower than 64. 58% in the control group (P<0. 05).
The follow-up period was from 4 to 31 months and the median follow-up period was 25 months until Mar. 2022. According to the
Log-Rank test, there was no statistically significant difference in the survival rate of autologous liver between two groups (P>0. 05).
Conclusion: Comprehensive drug management after Kasai surgery in CBA children can improve the jaundice clearance rate, reduce the
incidence of postoperative cholangitis, without increasing the incidence of hormone-related complications, which does not prolong the
one-year and two-year survival of autologous liver. |
| Key words: congenital biliary atresia Kasai surgery comprehensive drug management complications jaundice clearance rate |
