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目的通过术前经皮肝穿刺胆道引流(PTBD),观察对恶性梗阻性黄疸患者免疫、炎症的影响。方法前瞻性选择2008年7月—2010年10月我科住院的19例恶性梗阻性黄疸患者,行(PTBD)胆道引流术,观察引流前、引流后、术后1d、6d指标变化。主要观察肝功级免疫炎症指标变化。结果术前胆道引流减黄可使肝功指标下降,差异性显著(P<0.01)。IL-8水平较术前明显下降,且差异性显著(P<0.01);TNF-a水平较引流前显著下降,差异性显著(P<0.05)。结论短期内(PTBD)可以降低肝功和TNF-a,血清TNF-a水平可以作为反应恶性梗阻性黄疸免疫、炎症反应状态较为敏感的因子。
Objective To observe the effects of percutaneous transhepatic biliary drainage (PTBD) on the immunity and inflammation in patients with malignant obstructive jaundice. Methods Nineteen patients with malignant obstructive jaundice hospitalized in our department from July 2008 to October 2010 were prospectively selected for biliary drainage (PTBD). The changes of indexes before and after drainage were observed at 1 and 6 days after operation. The main observation of liver function changes in immune inflammation. Results Preoperative drainage of the biliary tract reduced the index of liver function, the difference was significant (P <0.01). The level of IL-8 was significantly lower than that before operation (P <0.01). The level of TNF-a was significantly lower than that before drainage (P <0.05). Conclusion Short-term (PTBD) can reduce liver function and TNF-a, serum TNF-a levels can be used as a response to malignant obstructive jaundice immunization, inflammatory response state is more sensitive factor.