Preoperative nutritional status and its impact on cholangitis after Kasai portoenterostomy in biliary atresia patients
Preoperative nutritional status and its impact on cholangitis after Kasai portoenterostomy in biliary atresia patients
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胆道闭锁患者Kasai门肠吻合术后术前营养状况及其对胆管炎的影响
DOI：
10.1007/s00383-017-4118-z
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发表时间：
2017-08-01
影响因子：
1.8
通讯作者：
Feng, Jiexiong
中科院分区：
文献类型：
--
作者：
Li, Dandan;Chen, Xiaoai;Feng, Jiexiong
为探讨胆道闭锁（BA）患者术前营养状况及其对加塞门肠吻合术（KPE）胆管炎发生的影响，将106例确诊为BA III型的KPE患者按STRONGkids评分分为两组。术前49例（46.2%）患者处于中度营养风险（MNR），57例（53.8%）患者处于高度营养风险（HNR）。MNR组的术后住院时间短于HNR组（P = 0.023）。MNR组患者术后首次胆管炎发生较晚（P = 0.002），早期胆管炎发生率低于HNR组（P = 0.029）。MNR组的黄疸清除率（P = 0.02）和2年自体肝生存率（P = 0.0109）均显著高于HNR组，BA组营养不良最严重，HNR组更易发生早期胆管炎，黄疸清除率低于MNR组。MNR组术后首次胆管炎的发生较HNR组晚。
To explore the preoperative nutrition status in patients with biliary atresia (BA) and its effect on the cholangitis of Kasai portoenterostomy (KPE).106 patients who had been diagnosed with BA type III and were undergoing KPE were divided into two groups according to the score obtained using STRONGkids. Preoperative and postoperative data were collected to compare general characteristics and postoperative outcomes between the different groups.Forty-nine (46.2%) patients were at moderate nutritional risk (MNR) and fifty-seven (53.8%) patients were at high nutritional risk (HNR) preoperatively. The MNR group had shorter postoperative hospitalization times than the HNR group (P = 0.023). The initial postoperative cholangitis occurred later (P = 0.002) and the incidence of early cholangitis was lower (P = 0.029) in patients at MNR than in those at HNR. The ratio of jaundice clearance (P = 0.02) and 2-year native liver survival (P = 0.0109) were significantly higher in MNR group than in HNR group.Patients with BA presented the greatest nutritional deficiencies and patients at HNR are more vulnerable to the early cholangitis and the rate of jaundice clearance is lower than those at MNR. The occurrence of initial postoperative cholangitis in MNR group was later than in HNR group.