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目的:探讨肝门部胆管癌术后口服胆汁患者的疗效。方法:采用病例对照法,回顾性分析2015年10月-2016年9月期间我科收治的肝门部胆管癌患者,术前行经皮肝穿刺胆道引流术(PTCD)并接受肝门部胆管癌根治术的患者89例,根据术后是否口服胆汁,将肝门部胆管癌患者分为两组,即口服胆汁组(51例)及对照组(38例)。所有患者均为术后3日开始进食。口服胆汁组:胆汁口服应遵循的条件为引流出的胆汁呈金黄色、无血性。术后第三天,胆汁满足口服的条件时,每6小时收集一次,经双层纱布过滤,胆汁中加入蜂蜜少量多次、随餐服下。对照组:除外口服胆汁,其余进食及治疗均相同。术后主要结局观察指标包括腹泻发生率、术后7天血清白蛋白水平,腹腔感染发生率;次要结局指标即住院时间。观察术后患者腹泻发生率、术后7天血清白蛋白水平,腹腔感染发生率和住院时间。结果:两组患者腹腔感染、腹泻发生及住院时间有统计学差异,p值均小于0.05,两组间白蛋白水平无统计学差异。结论:口服胆汁是一种有效、简便且经济的方法。术后腹腔感染并发症少,缩短住院时间,腹泻发生率较低。
Objective: To investigate the efficacy of postoperative oral bile in patients with hilar cholangiocarcinoma. Methods: A case-control study was performed to retrospectively analyze the patients with hilar cholangiocarcinoma admitted to our department from October 2015 to September 2016. Percutaneous transhepatic biliary drainage (PTCD) and preoperative hepatic hilar cholangiocarcinoma There were 89 patients undergoing radical operation. Patients with hilar cholangiocarcinoma were divided into two groups according to whether oral bile was given or not, namely, oral bile group (51 cases) and control group (38 cases). All patients began to eat on the 3rd postoperative day. Oral bile group: oral bile should follow the conditions for the drainage of the bile was golden yellow, non-bloody. The third day after surgery, bile to meet the conditions of oral administration, collected once every 6 hours, filtered through a double gauze, bile honey added a small amount of times, with the meals. Control group: except oral bile, the rest of eating and treatment are the same. The main postoperative outcome measures included the incidence of diarrhea, serum albumin level at 7 days postoperatively and incidence of intra-abdominal infection; the secondary outcome measure was hospital stay. The incidence of postoperative diarrhea, serum albumin level 7 days after surgery, the incidence of abdominal infection and hospital stay were observed. Results: There were significant differences in the incidence of abdominal infection, diarrhea and hospital stay between the two groups, with p values less than 0.05. There was no significant difference in albumin levels between the two groups. Conclusion: Oral bile is an effective, simple and economical method. Postoperative intra-abdominal infection less complications, shorter hospital stay, lower incidence of diarrhea.