Shabunin A V, Tarabrin V I, Malyshev I Iu
Khirurgiia (Mosk). 1998(11):49-51.
The aims of the study were: 1) to determine optimal duration of bile ducts decompression (BDD) and terms for radical operation performance; 2) to define criteria of effectiveness of the decompression and readiness of the patients for radical surgical treatment; 3) to analyze disorders in liver function and indices of immunoreactivity in relation to the method and duration of BDD; 4) to develop method of immunocompression for increase of effectiveness of BDD. The patients were divided in to three groups. 28 patients of group 1 had duration of jaundice up to 5 days and bilirubinemia up to 86.3 +/- 3.12 mmol/l. 35 patients of group 2 jaundice up to 15 days and bilirubinemia up to 184.7 +/- 4.22 mmol/l. In group 342 patients had bilirubinemia up to 124.4 +/- 2.23 mmol/l and cholangitis. External decompression of bile ducts quickly promotes restoration of drainage function of the liver and normalization of biochemical indexes. Restoration of immunological indexes in groups 2 and 3 is progressing slowly and demands immunocorrection. Indexes of immunoreactivity and biochemical data of functional status of the liver could serve as criteria of effectiveness of bile ducts decompression and possibility of radical surgical treatment. Regional immunocorrection is indicated for the patients' preparation for surgery.
1）确定胆管减压（BDD）的最佳持续时间和进行根治性手术的条件；2）明确减压效果标准以及患者接受根治性手术治疗的准备情况；3）分析肝功能紊乱和免疫反应指标与BDD方法及持续时间的关系；4）开发免疫抑制方法以提高BDD的效果。患者被分为三组。第一组28例患者，黄疸持续时间长达5天，胆红素血症高达86.3±3.12 mmol/l。第二组35例患者，黄疸持续时间长达15天，胆红素血症高达184.7±4.22 mmol/l。第三组42例患者，胆红素血症高达124.4±2.23 mmol/l且患有胆管炎。胆管外减压能迅速促进肝脏引流功能的恢复和生化指标的正常化。第二组和第三组免疫指标的恢复进展缓慢，需要进行免疫纠正。免疫反应指标和肝脏功能状态的生化数据可作为胆管减压效果及根治性手术治疗可能性的标准。对于准备手术的患者，建议进行局部免疫纠正。
