Gal'perin E I, Kotovskiĭ A E, Momunova O N
Kurs khirurgicheskoĭ gepatologii pri kafedre khirurgii FPPOV; otdel khirurgii pecheni Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova, Gorodskaia klinicheskaia bol'nitsa #7.
Khirurgiia (Mosk). 2011(8):33-40.
Results of biliary decompression were analyzed in 185 patients with malignant obstructive jaundice. Among them 85 patients underwent nasobiliary drainage, 37 - percutaneous transhepatic bile drainage and 63 - cholecystectomy. Dynamics in biochemical indices of blood serum, cholangiomanometry and jaundice response to decompression according to T. Shimizu et K.Yoshida's formula in our modification were evaluated for estimation of bile flow rate. It is ascertained that application of nasobiliary drainage leads to low-rate decompression, percutaneous transhepatic bile drainage and cholecystectomy - to high-rate decompression. Low-rate decompression enables to decrease significantly the frequency of "fast decompression syndrome" and complications, particularly augmenting of liver dysfunction, multiple organ failure and lethality in post-decompression period related to them.
对185例恶性梗阻性黄疸患者的胆道减压结果进行了分析。其中85例行鼻胆管引流,37例行经皮经肝胆道引流,63例行胆囊切除术。根据我们改良的T. Shimizu和K. Yoshida公式,评估血清生化指标的动态变化、胆管测压以及减压后黄疸的反应,以估计胆汁流速。结果确定,鼻胆管引流导致低速率减压,经皮经肝胆道引流和胆囊切除术导致高速率减压。低速率减压能够显著降低“快速减压综合征”及并发症的发生率,特别是与它们相关的减压后肝功能障碍、多器官功能衰竭和死亡率的增加。