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目的探讨恶性梗阻性黄疸(malignant obstructive jaundice,MOJ)术前各种因素与术后肝功能恶化之间的联系,为合理评估MOJ患者的围术期状况提供参考。方法分析376例患者临床资料,按照是否出现术后肝功能恶化分为两组,将两组术前术中各项指标进行Binary Logistic回归分析,筛选出的变量进行Bayes判别分析,建立判别方程,并予以验证。结果 376例患者术后肝功能恶化49例,发生率13.0%;Binary Logistic过程筛选出年龄、TBIL、ALB、ALP、术前减黄、术中出血量为术后肝功能恶化的影响因素,Bayes判别分析建立的预测方程经验证稳定。结论年龄、TBIL、ALB、ALP、术前减黄、术中出血量为术后肝功能恶化的影响因素,通过判别分析方程,可以用数学的方法客观地计算出MOJ术后肝功能恶化的危险程度,为临床及早干预提供参考。
Objective To investigate the relationship between various factors of preoperative malignant obstructive jaundice (MOJ) and postoperative deterioration of liver function, and to provide a reference for reasonable assessment of the perioperative status of patients with MOJ. Methods Clinical data of 376 patients were analyzed and divided into two groups according to whether there was postoperative deterioration of liver function. Binary Logistic regression analysis was used to analyze the indexes of the two groups before surgery. The variables selected were analyzed by Bayes discriminant analysis to establish the discriminant equation, And verify. Results In 376 patients, postoperative deterioration of liver function was found in 49 cases (13.0%). The age, TBIL, ALB and ALP were screened by Binary Logistic process. The preoperative yellowing and blood loss were the influencing factors of postoperative liver function deterioration. Bayes The predictive equation established by discriminant analysis is verified and stable. Conclusions Age, TBIL, ALB, ALP, preoperative reduction of yellowing and intraoperative blood loss are the influencing factors of postoperative liver function deterioration. By discriminant analysis equation, the risk of deterioration of liver function after MOJ can be objectively calculated by mathematical method The degree of clinical and early intervention provide a reference.