胆汁转流性外引流术对恶性梗阻性黄疸血内毒素水平的影响

目的 :探讨外引流术体外转流胆汁对恶性梗阻性黄疸病人血内毒素水平的影响。方法 :对 14例肿瘤手术不能切除的恶性梗阻性黄疸病人行胆汁转流性外引流术 ,与同期施行的 15例内引流术、2 0例外引流术病人进行手术前后外周血内毒素水平比较。结果 :术前 3组内毒素水平差别无显著性意义 (P>0 .0 5 )。单纯外引流组手术后内毒素水平略高于术前 (P >0 .0 5 ) ;内引流组术后第 2天内毒素水平反而高于术前 (P <0 .0 5 ) ,第 7天、第 14天显著降低 (P <0 .0 5 ,P <0 .0 1) ;体外转流组术后内毒素水平逐渐降低 ,与内引流术组变化基本相同。结论 :胆汁转流性外引流术可降低恶性梗阻性黄疸病人外周血内毒素水平。

Effect of external biliary drainage with bile extracorporeal bypass on blood endotoxin level in patients with malignant obstructive jaundice

Objective:To observe the change of blood endotoxin level after external biliary drainage with bile extracorporeal bypass in patients with malignant obstructive jaundice.Methods:The external biliary drainages with bile extracorporeal bypass were undergone in 14 patients with malignant obstructive jaundice,peripheral blood endotoxin levels were measured in perioperative period, other 15 cases internal biliary drainage and 20 cases external biliary drainage as contrast.Results:The changes of endotoxin level were not significant in external biliary drainage group,however,the endotoxin level was decreased signficantly in internal biliary drainage or external biliary drainage with bile extracorporeal bypass at postoperation.Conclusion:The external biliary drainage with bile extracorporeal bypass can decrease postoperative blood endotoxin level in patients with malignant obstructive jaundice.