梗阻性黄疸手术时机的选择

目的高胆红素血症引起多脏器功能损害，致使患者手术耐受性下降，危险性增加，手术前行胆道引流能否改善梗阻性黄疽动物模型各脏器的病理、生理状况。方法通过对梗阻性黄疸动物模型分别采取术前胆道引流及非胆道引流观察。结果引流组解除梗阻后两周与模型组比较ＣＲＥＡ、ＴＢＩＬ、ＤＢＩＬ改善，ｔ检验Ｐ＜０．０５有显著性差异，但电解质紊乱，ＴＰ、ＡＬＢ继续下降，各脏器的病理变化与模型组对比无明显差异。结论短期内体外引流并未明显改善各脏器功能及病理状况，反而造成水电解质紊乱，增加逆行感染，对病人治疗及预后是无益的。

Timing of operation on obstructive jaundice

Objective To Study whether drainage of bile before operation can improve the pathophysiolog-ical status of the obstructive jaundice in an animal model. Method We studied the difference between thedrainage group and non-drainage group of the Obstructive jaundice in rabbits. Result Comparing to the non-drainage model group, the values of CREA, TBIL, DBIL of the drainage group improved two weeks after removalof obstruction (P < 0.05),however, fluid and electrolytes disorders happened, and the values of TB, ALB de-creased continuously. There was no remarkable difference in pathophysiological changes between the two groups.Conclusion Short period of external drainage of bile can not improve the function and pathological changes ofvarious organs, but leads to fluid and electrolytes disorders, increases the rate of retrograde infection, and makesno benefit in treatwent and prognosis.