Gal'perin E I, Momunova O N
Khirurgiia (Mosk). 2014(1):5-9.
It was analyzed the results of examination and surgical treatment of 338 patients with obstructive jaundice. The patients were operated in 2004-2012 years. 148 patients had benign jaundice and 190 patients had malignancy genesis of jaundice. It was determined laboratory data (bilirubin total, protein total, prothrombin index) as well as complications of obstructive jaundice (cholangitis, renal failure, hepatic encephalopathy, gastrointestinal bleeding, sepsis) indicating to the severity of obstructive jaundice and it was taken into consideration the malignant origin of jaundice. The selected attributes were assigned marks from 1 to 3. Each complication as well as factor of malignancy was evaluated two times higher than mark of bilirubin. The grade of jaundice severity (A, B, C) was determined by combination of the marks that identified the attributes. It was analyzed the influence of prothrombin index and blood serum protein on the results of severity grade formation of obstructive jaundice with the postoperative results (lethality, complications). It was done for simplification of classification. The absence of significant differences in assessing of the severity obstructive jaundice class with and without attributes of a "total protein" and "prothrombin index". To simplify the classification and to get more reliable information about the difference of postoperative results between the grades (A, B, C) are possible by exception of total protein attributes and prothrombin index.
分析了338例梗阻性黄疸患者的检查和手术治疗结果。这些患者于2004年至2012年接受手术。148例患者为良性黄疸，190例患者为恶性黄疸。确定了实验室数据（总胆红素、总蛋白、凝血酶原指数）以及梗阻性黄疸的并发症（胆管炎、肾衰竭、肝性脑病、胃肠道出血、败血症），这些指标表明梗阻性黄疸的严重程度，并考虑了黄疸的恶性起源。所选属性被赋予1到3分。每种并发症以及恶性因素的评分是胆红素评分的两倍。黄疸严重程度分级（A、B、C）由确定属性的评分组合确定。分析了凝血酶原指数和血清蛋白对梗阻性黄疸严重程度分级结果与术后结果（死亡率、并发症）的影响。这样做是为了简化分类。在评估梗阻性黄疸严重程度分级时，有无“总蛋白”和“凝血酶原指数”属性之间没有显著差异。通过排除总蛋白属性和凝血酶原指数，可以简化分类并获得关于各分级（A、B、C）术后结果差异的更可靠信息。
