Hunt D R
Aust N Z J Surg. 1980 Oct;50(5):476-80. doi: 10.1111/j.1445-2197.1980.tb04173.x.
In the presence of obstructive jaundice, surgical procedures are associated with high rates of mortality and morbidity. In an endeavour to identify risk factors associated with a poor outcome, a detailed prospective study of 28 jaundiced patients has been performed. Factors associated with a fatal outcome of operation were serum bilirubin level > 300 mumol/1, glomerular filtration rate < 50 ml/min, the presence of an abnormal level of fibrin degradation products (FDP) in serum, and the presence of endotoxaemia. Postoperative deep venous thrombosis was associated with low serum albumin, normal liver enzymes and rapid kaolin clotting time. Postoperative haemorrhage occurred in patients with FDP or endotoxaemia. Patients with normal renal function or elevated levels of liver enzymes were protected from sepsis. Based on the identification of these risk factors and of those patients with inoperable disease, a plan for management is proposed.
在存在梗阻性黄疸的情况下，外科手术伴有高死亡率和高发病率。为了确定与不良预后相关的危险因素，对28例黄疸患者进行了详细的前瞻性研究。与手术致命结局相关的因素有血清胆红素水平>300μmol/L、肾小球滤过率<50ml/min、血清中纤维蛋白降解产物（FDP）水平异常以及存在内毒素血症。术后深静脉血栓形成与低血清白蛋白、正常肝酶和快速高岭土凝血时间有关。FDP或内毒素血症患者发生术后出血。肾功能正常或肝酶水平升高的患者可预防败血症。基于对这些危险因素以及患有无法手术疾病患者的识别，提出了一项管理计划。
