Objective:To study the clinical effect of ultrasound-guided percutaneous transhepatic cholangial drainage(PTCD)in the treatment of advanced malignant obstructive jaundice(MOJ)and to analyze the factors affecting the prognosis.Methods:A retrospective study was conducted on 90 patients with advanced MOJ who were treated with ultrasound-guided PTCD in the hospital from January 2019 to December 2021.Clinical data of the patients were collected in detail,and the improvement effects of liver function,jaundice and bile duct diameter were evaluated at the end of 7 days after surgery,and the occurrence of postoperative complications were observed and followed up for one year.A multivar-iate Cox regression model was used to analyze the factors of prognosis.Results:Seven days after ultrasound-guided PTCD treatment,the levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)and bile duct diameter of patients with MOJ were reduced,while serum albumin(ALB)level was enhanced as compared with that respectively before treatment(P<0.05).During 1 year of follow-up,5 cases(5.56%)were lost to follow-up,56 cases(62.22%)died and 29 cases(32.22%)survived.The median overall survival(OS)was 7.0 months(95%CI:5.4-8.6).The proportions of liver cancer,high obstruction,and liver function Child-Pugh grade C,as well as the levels of serum ALT,AST,TBIL,and hypersensitive C-reactive protein(hs-CRP)in the death group,were all higher than those in the survival group,while serum ALB level was lower than that in survival group(P<0.05).Multivariate Cox regression analysis showed that liv-er cancer,high obstruction,and liver function grade C were risk factors for death(P<0.05),and ALB was a protective factor for death(P<0.05).Conclusion:Ultrasound-guided PTCD has a good effect in the treatment of advanced MOJ,and it can effectively relieve biliary tract obstruction and pro-mote liver function recovery,but its prognosis is still poor.Tumor type,obstruction site,liver func-tion grading,and ALB level are all important factors affecting the prognosis of patients.
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