Đánh giá mức độ ưu tiên ghép gan qua thang điểm Peld trong phẫu thuật Kasai điều trị teo đường mật bẩm sinh type III=Evaluating liver transplant priority using the peld score in patients undergoing Kasai surgery for biliary atresia type III

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Tuyết Trinh Nguyễn, Tiến Tùng Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y Dược Thái Bình (Đại học Y Dược Thái Bình), 2024

Mô tả vật lý: tr.10-13

Bộ sưu tập: Metadata

ID: 156820

Thêm vào giỏ

Đánh giá mức độ ưu tiên ghép gan của bệnh nhi teo đường mật bẩm sinh type III được điều trị bằng phẫu thuật Kasai tại bệnh viện Nhi trung ương qua thang điểm PELD.Phương pháp: Nghiên cứu hồi cứu mô tả loạt ca bệnh bao gồm 172 bệnh nhân được chẩn đoán teo đường mật bẩm sinh type III, được điều trị bằng phẫu thuật Kasai có cắt xơ rốn gan rộng rãi tại bệnh viện Nhi trung ương từ 01/2016 đến 12/2020. Chỉ tiêu nghiên cứu là thang điểm PELD (Pediatric End –stage Liver – Disease) là chỉ số để chỉ định ưu tiên cho trẻ teo đường mật bẩm sinh cần ghép gan.Kết quả: Thang điểm PELD đánh giá trước mổ trung bình là 5,68±9,3. Đánh giá lại sau 01 tháng thang điểm PELD trung bình là 5,91±3,31. Đánh giá lại sau 06 tháng, điểm PELD trung bình là 5,33±8,12. Chỉ số PELD sau phẫu thuật ở nhóm bệnh nhân tử vong cao hơn so với nhóm còn sống với diện tích dưới đường cong ROC đạt 0,869 (0,788-0,950) với p=0,006, tại ngưỡng (cut off) PELD≥3 với độ nhạy 91,7% và độ đặc hiệu 63,9%.Kết luận: Thang điểm PELD trước mổ và sau mổ 6 tháng có liên quan chặt chẽ tới tỷ lệ tử vong sau phẫu thuật Kasai và ưu tiên trong ghép gan điều trị teo đường mật bẩm sinh ở trẻ em.To evaluate the prioritization of liver transplantation for pediatric patients with biliary atresia type III treated by Kasai surgery at the National Children’s Hospital using the PELD score. Method: A retrospective descriptive study of a series of 172 patients diagnosed with biliary atresia type III and treated with Kasai surgery involving extensive resection around the hepatic hilum at the National Children’s Hospital f-rom January 2016 to December 2020. Results: The average preoperative PELD score was 5.68±9.3. One month post-surgery, the average PELD score was 5.91±3.31. Six months post-surgery, the average PELD score was 5.33±8.12. The postoperative PELD score in the deceased patient group was higher than in the surviving group, with an area under the ROC curve of 0.869 (0.788-0.950) and p=0.006, at a PELD cut-off of ≥3 with a sensitivity of 91.7% and specificity of 63.9%. Conclusion: The preoperative and 6-month postoperative PELD scores are closely related to mortality rates after Kasai surgery and prioritization for liver transplantation in the treatment of biliary atresia in children.

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