埃塞俄比亚亚的斯亚贝巴耶卡提特第 12 医院医学院对阻塞性黄疸及其相关因素的管理结果评估

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摘要

背景:阻塞性黄疸是日常临床实践中常见的问题,也是规划当前和未来治疗最具挑战性的病症之一。其原因多种多样,但最常见的原因是胆总管结石、胆道良性狭窄、胰胆恶性肿瘤和转移性疾病。一般认为,对梗阻性黄疸患者进行手术治疗,并发症和死亡率较高。研究目的本研究旨在评估埃塞俄比亚亚的斯亚贝巴耶卡提特 12 医院医学院阻塞性黄疸的治疗效果及相关因素:研究采用纵向研究设计,纳入了自2022年5月1日至2023年4月30日期间外科病房收治的所有因阻塞性黄疸而接受手术的患者。采用卡方检验(Chi square fisher's exact test)来检验梗阻性黄疸结果与自变量之间的关系,以P值小于0.05为显著性:本研究共纳入 31 名患者,平均年龄(49.03 SD±16.16 岁)。在确诊为阻塞性黄疸的患者中,大多数是由良性原因引起的。胆总管结石是最常见的良性病症,占 88.2%,髓周癌是恶性阻塞性黄疸最常见的病因(48.4%)。在接受手术的患者中,38.7%接受了分流术。9名患者(24.3%)出现术后并发症,其中手术部位感染最为常见(55.5%)。术后并发症类型与治疗结果之间存在显著关联(P=0.034):结论:阻塞性黄疸最常见的原因是胆管结石。结论:梗阻性黄疸最常见的病因是胆管结石,术后并发症与梗阻性黄疸的治疗结果有明显关联。
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Management Outcome Assessment of Obstructive Jaundice and Associated Factor from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia
Background: Obstructive jaundice is common problem in daily clinical practice and among the most challenging conditions for planning current and future management. The causes are varied, but it is most commonly due to choledocholithiasis; benign strictures of the biliary tract, pancreaticobiliary malignancies, and metastatic disease. Surgery in patients with obstructive jaundice is generally considered to be associated with a higher incidence of complication and mortality. Objective: The purpose of the study was to assess outcome of obstructive jaundice and associated factors at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia. Methods: A longitudinal study design was used to conduct the study and all patients admitted to the surgical wards for whom surgery was done for obstructive jaundice from May 1, 2022 to April 30, 2023 G.C were included. Chi square fisher’s exact test was used to see the association between obstructive jaundice outcome and independent variables, significance was determined by p-value <0.05. Results: In these study 31 patients were enrolled and the mean age was 49.03 SD±16.16 years. Of patients diagnosed to have obstructive jaundice majority are due to benign causes. Common bile duct stones are the commonest benign condition accounting 88.2% and peri-ampullary cancers are the most frequent (48.4%) cause of obstructive jaundice from malignant condition. Among patients operated 38.7% were underwent bypass procedures. Post-operative complications occurred in 9 (24.3. %) of patients, with surgical site infection being commonest (55.5%). Significant association was identified between types of post-operative complication and management outcome (P=0.034). Conclusion: The most common cause of obstructive jaundice was bile duct stone. Post-operative complications were significantly associated with management outcome of obstructive jaundice.
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