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作者总结了1989年~1994年对45例恶性梗阻性黄疸患者行根治性手术或单纯内/外引流手术的经验。术后发生肾功能衰竭,胃肠道出血,伤口愈合不良等并发症。且肾衰及胃肠道出血与高胆红素血症相关。此外,部分患者合并有营养不良,血糖升高及脂代谢异常,直接影响着伤口愈合率。低葡萄糖热卡的营养支持有助于改善病人的营养状况。另外,对于严重胆道梗阻,近期不能手术或合并化脓性胆管炎患者术前应恰当地行胆道减压引流,并配合全身支持治疗。
The authors summarized the experience of radical surgery or internal/external drainage surgery in 45 patients with malignant obstructive jaundice from 1989 to 1994. Kidney failure, gastrointestinal bleeding, poor wound healing and other complications occurred after surgery. Renal failure and gastrointestinal bleeding are associated with hyperbilirubinemia. In addition, some patients with malnutrition, elevated blood sugar and abnormal lipid metabolism directly affect the rate of wound healing. The nutritional support of the low glucose calorie helps improve the patient’s nutritional status. In addition, for severe biliary obstruction, patients who cannot be operated or combined with suppurative cholangitis should be treated with biliary decompression and drainage before surgery and with systemic support.