[1]杨亚兵,王玲,曹迁,等.肝内胆管结石罹患胆管癌的预后因素分析[J].中国微创外科杂志,2018,18(5):385-400.
　Yang Yabing,Wang Ling,Cao Qian,et al.Prognostic Factors of Hepatolithiasis With Cholangiocarcinoma[J].Chinese Journal of Minimally Invasive Surgery,2018,18(5):385-400.
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肝内胆管结石罹患胆管癌的预后因素分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年5期
页码:
385-400
栏目:
临床论著
出版日期:
2018-09-04

文章信息/Info

Title:
Prognostic Factors of Hepatolithiasis With Cholangiocarcinoma
作者:
杨亚兵; 王玲; 曹迁; 凌晓锋**; 徐智; 王立新; 侯纯升; 王港; 崔龙
北京大学第三医院普通外科，北京100191
Author(s):
Yang Yabing;  Wang Ling;  Cao Qian;  et al.
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
关键词:
肝内胆管结石; 胆管癌; 预后因素
Keywords:
Hepatolithiasis; Cholangiocarcinoma; Prognostic factors
文献标志码:
A
摘要:
目的探讨肝内胆管结石罹患胆管癌的预后因素。方法回顾分析我院2006年1月~2017年2月肝内胆管结石中26例罹患胆管癌（病例组）和386例非胆管癌（对照组）的临床资料，采用单因素和logistic回归模型多因素分析肝内胆管结石罹患胆管癌的预后因素。结果单因素分析结果显示，肝脓肿、肝硬化、门静脉高压、病肝切除、胆管狭窄矫正、结石完全清除2组差异有显著性（P<0.05）。病例组胆管狭窄发生率57.7%(15/26)，高于对照组38.3%(148/386)，但差异无统计学意义（χ2=3.815,P=0051）。logistic回归模型多因素分析显示肝硬化（OR=4.873，95% CI：1.310~18.126，P=0018)、结石残留（OR=27.579，95% CI：6.275~121.214，P=0.000)为肝内胆管结石罹患胆管癌的独立预后因素，胆管狭窄矫正（OR=0018, 95% CI：0.092~0.564，P=0.000)为独立保护因素。结论在治疗肝内胆管结石的过程中，要做到早发现早治疗，及时控制感染，积极地进行手术，预防肝脓肿、肝硬化及门静脉高压的发生，同时尽可能彻底清除结石，纠正胆管狭窄，切除病肝。
Abstract:
ObjectiveTo analyze the prognostic factors of hepatolithiasis with cholangiocarcinoma.MethodsClinical data of hepatolithiasis with (case group, n=26) and without (control group, n=386) cholangiocarcinoma in our hospital from January 2006 to February 2017 were reviewed. Univariate analysis and logistic regression analysis were applied to analyze the prognostic factors of hepatolithiasis with cholangiocarcinoma.ResultsUnivariate analysis showed that there were significant differences between the two group in hepatic abscess, liver cirrhosis, portal hypertension, morbid hepatectomy, clearance of stones, and correction of biliary stricture (P<0.05). The was no significan difference in the incidence of biliary stricture between the two groups［the case group:557%(15/26) vs. the control group:38.3%(148/386), χ2=3.815,P=0.051］. Logistic regression analysis illustrated that liver cirrhosis (OR=4.873, 95%CI: 1.310-18.126, P=0.018) and residual stones (OR=27.579, 95%CI: 6.275-121.214, P=0.000) were independent prognostic factors. The biliary stricture correction (OR=0.018, 95%CI: 0.092-0.564, P=0.000) was an independent protective factor.ConclusionsFor the hepatolithasis management, every effort should be made to achieve early detection and treatment, which could prevent liver abscess, liver cirrhosis and portal hypertension. Clearance of stones, correction of stenosis, and morbid hepatectomy should be applied during the operation.

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备注/Memo

备注/Memo:
基金项目：北京市自然科学基金资助（7172233）**通讯作者，E-mail：xiaofengling2005@126.com
更新日期/Last Update: 2018-09-04