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囊肿型与非囊肿型Ⅲ型胆道闭锁预后的对比研究 被引量:2

Comparative study of prognosis between cystic and non - cystic type Ⅲ biliary atresia
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摘要 目的探讨Ⅲ型胆道闭锁中囊肿型与非囊肿型的预后情况。方法回顾性分析2008年7月至2011年6月收治于首都医科大学附属北京儿童医院普通外科的Ⅲ型胆道闭锁患儿共98例,其中囊肿型7例,非囊肿型91例。按术后总胆红素降至正常的时间,以3个月、6个月为时间截点,分为优(〈3个月)、良(3~6个月)、差(〉6个月)3组。对比囊肿型与非囊肿型患者在优、良、差组中所占比例,以评估2组患儿退黄速度的快慢;绘制生存曲线比较2组3年生存率情况。结果7例囊肿型胆道闭锁中,优2例,良3例,差2例;91例非囊肿型胆道闭锁中,优33例(36.3%),良26例(28.6%),差32例(35.1%)。囊肿型与非囊肿型的手术日龄分别为(98.14±47.42)d和(76.95±22.38)d,差异无统计学意义(t=1.172,P=0.284)。囊肿型与非囊肿型术后自肝生存率分布差异无统计学意义(P=0.398),其中1年、2年、3年的自肝生存率分别为85.7%(6/7例)和65.9%(60/91例)、71.4%(5/7例)和58.2%(53/91例)、71.4%(5/7例)和52.8%(48/91例)。囊肿型和非囊肿型的3年自肝生存率分别为优组100.0%(2/2例)和75.8%(25/33例),良组100.0%(3/3例)和69.2%(18/26例),差组0和15.6%(5/32例),二者差异均无统计学意义。结论Ⅲ型胆道闭锁中,囊肿型术后的退黄速度及术后3年自肝生存率与非囊肿型相当。Kasai术后6个月内达完全退黄者,预后良好。 Objective To compare the prognosis between cystic and non -cystic type m biliary atresia. Methods From July 2008 to June 2011,98 patients diagnosed as type m biliary atresia were admitted into Department of General Surgery, Beijing Children's Hospital Affiliated to Capital Medical University. There were 7 cystic and 91 non - cystic biliary atresia patients, and the data were retrospectively analyzed. According to the intervals between Kasai surgery and jaundice free, patients were divided into excellent ( 〈 3 months) , favorable (3 -6 months) and unfavorable ( 〉 6 months ) groups. The constituent ratios of excellent, favorable and unfavorable groups were compared between cystic and non - cystic patients to estimate the postoperative jaundice free rate. The native liver survival rates were compared between cystic and non - cystic patients with survival curve analysis. Results Among 7 cystic biliary atresia patients,there were 2 excellent, 3 favorable and 2 unfavorable patients. Among 91 non - cystic biliary atresia patients, there were 33 excellent cases (36.3%) ,26 favorable cases (28.6%) and 32 unfavorable cases ( 35.1% ) of patients. The operation ages of cystic and non - cystic patients were (98.14 ±47.42) days and (76.95 ±22.38 ) days,respectively,with no statistical difference( t = 1. 172,P = 0. 284). There were no statistical differences of the native liver survival rate between cystic and non - cystic patients ( P = 0. 398 ) , with 1 - year,2 - year and 3 - year native liver survival rate 85.7% (6/7 cases) and 65.9% (60/91 cases) ,71.4% (5/7 cases) and 58.2% (53/91 cases) ,71.4% (5/7 cases ) and 52.8% (48/91 cases), respectively. The 3 - year native liver survival rate of excellent, favorable and non - favorable groups between cystic and non - cystic patients were 100.0% (2/2 cases) and 75.8% (25/33 cases), 100.0% (3/3 cases) and 69.2% (60/91 cases), 0 and 15.6% (5/32 cases), respectively, with no statistical differ
作者 沈秋龙 陈亚军 张廷冲 彭春辉 庞文博 王增萌 吴东阳 肖广阔 Shen Qiulong, Chen Yajun,Zhang Tingchong , Peng Chunhui, Pang Wenbo , Wang Zengmeng , Wu Dongyang , Xiao Guangkuo. (Department of General Surgery, Beijing Children's Hospital Affiliated to Capital Medical University ,Beijing 100045, China)
出处 《中华实用儿科临床杂志》 CSCD 北大核心 2015年第23期1792-1794,共3页 Journal of Applied Clinical Pediatrics
基金 天津市卫生行业重点攻关项目(14KG129)
关键词 胆道闭锁 囊肿型 预后 自肝生存率 Biliary atresia, cystic Prognosis Native liver survival rate
作者简介 通信作者:陈亚军,Email:chenyajunmd@aliyun.com
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