摘要
目的探讨经内镜逆行性胰胆管造影术(ERCP)与经皮肝穿刺胆道引流术(PTCD)途径胆道支架置入治疗老年低位恶性梗阻性黄疸的临床应用效果,为老年低位恶性梗阻性黄疸患者提供临床最佳治疗方式。方法回顾性分析2018年8月至2021年8月期间济宁市第一人民医院收治的140例老年低位恶性梗阻性黄疸患者的临床资料。按照治疗术式不同,分为ERCP组与PTCD组。对比2组患者手术成功率、血清总胆红素下降情况、术后常见并发症发生率、住院时间、住院费用、手术费用成本及相关临床指标。结果ERCP组与PTCD组手术成功率分别为94.74%、84.38%,差异均有统计学意义(P=0.042);术后血清总胆红素下降值分别为(189.26±9.16)μmol/L、(151.65±11.56)μmol/L,差异均有统计学意义(P<0.05);并发症发生率分别为9.21%vs 23.43%,差异有统计学意义(χ^(2)=5.309,P=0.021);ERCP组与PTCD组患者住院时间分别为(9.43±2.05)d和(10.92±2.90)d,差异有统计学意义(P=0.001),住院费用分别为(35607.65±591.45)元和(46799.45±88.81)元,差异有统计学意义(P=0.01),手术费用分别为(18360.41±88.47)元和(25160.73±98.21)元,差异有统计学意义(P=0.003)。结论经ERCP途径胆道支架置入治疗老年低位恶性梗阻性黄疸具有手术风险小、微创手术治疗成功率高、相关并发症发生率低、治疗成本及住院时间相对较低、疗效好的优点,效果优于经PTCD途径。
Objective To evaluate the effectiveness of biliary stent placement by endoscopic retrograde cholangiopancreatography(ERCP)versus percutaneous transhepatic cholangial drainage(PTCD)in the treatment ofsenile malignant low biliary obstructive jaundice.Methods The clinical data of 140 patients with malignant biliary obstruction treated at Jining NO.1 People’s Hospital from Aug.2018 to Dec.2020 were retrospectively analyzed.All the patients were divided into ERCP group and PTCD group by treatment method.The related outcomes of two groups were compared including the success rate of surgery,the decrease level of serum bilirubin on the 5th day after the treatment and the rate of complications.Results Significant difference was detected in the two groups on success rate of surgery(94.74%vs 84.38%P=0.042).ERCP had significantly reduced the level of serum bilirubin on the 5th day after the treatment and the rate of complications[(189.26±9.16)μmol/L vs(151.65±11.56)μmol/L,P<0.05],compared with PTCD.Significant difference was detected in the two groups on the incidence of postoperative complications(9.21%vs 23.43%,χ^(2)=5.309,P=0.021).There was significant difference between the two groups(P=0.01),and the hospitalization time of ERCP group and PTCD group were(9.43±2.05 vs 10.92±2.90)d,and hospitalization costs were(35607.65±591.45 vs 46799.45±888.81)¥.The significant difference was detected in the two groups on surgery costs were(18360.41±88.47 vs 25160.73±98.21)￥(P=0.003).Conclusion For senile low malignant biliary obstructive jaundice,biliary stent implantation by ERCP had less trauma,fewer complications,rapid onset of efficacy and better results.Biliary stent implantation by ERCP can improve the success rate of surgery,in a timely manner to relieve symptomsand heighten patients'live quality,is better than biliary stent implantation by PTCD.
作者
王宁
杨村
李洪运
孟庆顺
WANG Ning;YANG Cun;LI Hongyun;MENG Qingshun(School of Clinical Medicine,Jining Medical University,Jining 272013,China;Jining NO.1 People’s Hospital,Jining 272011,China)
出处
《济宁医学院学报》
2022年第6期405-409,共5页
Journal of Jining Medical University
关键词
老年低位恶性梗阻性黄疸
逆行性胰胆管造影术
经皮肝穿刺胆道引流术
胆道支架
Senile low malignant biliary obstructive jaundice
Endoscopic retrograde cholangiopancreatography
Percutaneous transhepatic cholangial drainage
Biliary stent
作者简介
通信作者:孟庆顺,E-mail:mengqingshun0609@163.com。
