摘要
目的探讨不同方式的胆汁引流对治疗恶性梗阻性黄疸的疗效。方法回顾性分析该院消化内科及肝胆外科2008年-2013年97例恶性梗阻性黄疸患者的临床资料。结果 97例患者中57例行经内镜逆行胰胆管造影引流术(ERCP)术(A组),成功率94.7%(54/57),40例行经皮肝穿刺胆管/胆囊引流术(PTCD/PTGD)术(B组),成功率95.0%(38/40)。术后患者腹痛、皮肤瘙痒等不适症状明显缓解。两组患者血清总胆红素、直接胆红素和碱性磷酸酶水平术后均明显降低,差异有显著性(P<0.05)。两组患者人均手术次数和术后住院时间差异无显著性(P>0.05)。B组患者并发症的发生率较A组明显增高(P<0.05)。结论 ERCP术和PTCD/PTGD术均为有效的姑息性治疗方法。但ERCP术并发症发生率低,能明显提高患者生活质量,且考虑内镜介入治疗的安全性,故ERCP术是失去手术机会或不愿手术的恶性梗阻性黄疸患者的首选治疗。
[Objective] To discuss the effects of malignant obstructive jaundice in different kinds of biliary drainage. [ Methods ] The clinical data of 97 patients with malignant obstructive jaundice were retrospectively ana- lyzed in Digestive System Department and Hepatobiliary Surgery at the First Affiliated Hospital of Shihezi University from 2008 to 2013. [Results] The 97 patients were divided into ERCP drainage group （group A, n =57）, PTCD/PT- GD group（group B, n =40）. The successful rate of ERCP was 94.7% （54/57）. PTCD/PTBD led to 95% （38/40） suc- cessful rate. The clinical symptoms such as abdominal pain, pruritus were relieved obviously. One week after drainage the levels of TBIL, DBIL and ALP of the patients undergoing treatment all decreased in comparison with those before the treatment （P 〈0.05）. The operation frequency in per capita and hospitalization duration after opera- tion in each group showed no significant difference （P 〉0.05）. The incidence of complications of group B was signifi- cantly higher than group A （P 〈0.05）. [ Conclusion ] ERCP and PTCD/PTGD drainage were both technically and clinically successful for palliative treatment of malignant biliary obstruction. With a lower incidence, ERCP drainage can obviously improve the quality of life, but we should consider the safety of endoscopic treatment, ERCP drainage is the first choice of patients with inoperable malignant biliary obstruction.
出处
《中国内镜杂志》
北大核心
2015年第4期371-374,共4页
China Journal of Endoscopy
关键词
恶性梗阻性黄疸
经内镜逆行胰胆管造影
经皮肝穿刺胆管/胆囊引流术
malignant obstructive jaundice
endoscopic retrograde cholangiopancreatography
percutaneous transhepatic cholangiography/gallbladder drainage
作者简介
【通信作者】郑勇，E-mail：zy2850@126．com；Tel：0993-2859284
