论文部分内容阅读
目的:探讨经皮肝穿刺胆管引流术(PTCD)基础上胆道内置入金属支架姑息性治疗恶性胆道梗阻的疗效。方法:回顾性分析2011年1月—2013年6月收治的经十二指肠镜逆行胰胆管造影(ERCP)支架植入失败后改行PTCD或PTCD联合胆道内金属支架置入的94例胆道恶性梗阻患者临床资料,其中,单纯行PTCD 45例(PTCD组),PTCD联合胆道内金属支架置入49例(PTCD+支架组),比较两组减黄效果、术后并发症及术后生存情况。结果:术后5 d,两组血清胆红素水平无统计学差异(P>0.05),但术后7、14 d,PTCD+支架组血清胆红素水平明显低于PTCD组(P<0.05);两组术后并发症发生率差异无统计学意义(P>0.05);PTCD+支架组术后1年的生存率优于PTCD组(χ2=6.280,P=0.012)。结论:PTCD基础上胆道内金属支架置入是恶性胆道梗阻患者ERCP失败后有效的姑息性治疗手段,且效果优于单独的PTCD。
Objective: To investigate the efficacy of percutaneous transhepatic biliary drainage (PTCD) on the basis of palliative placement of metal stent in the treatment of malignant biliary obstruction. Methods: A retrospective analysis of 94 patients with malignant biliary tract who underwent transcranial PTCD or PTCD combined with biliary stent implantation after laparoscopic ERCP was performed in our hospital from January 2011 to June 2013 was retrospectively analyzed. Obstructive patients with clinical data, including simple PTCD 45 cases (PTCD group), PTCD combined with biliary metal stent 49 cases (PTCD + stent group), the two groups compared the effect of yellowing, postoperative complications and postoperative survival. Results: Serum bilirubin level was not significantly different between the two groups on the 5th postoperative day (P> 0.05). However, serum bilirubin levels in the PTCD + stent group were significantly lower than those in the PTCD group on the 7th and 14th postoperative day (P <0.05) There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). The survival rate of PTCD + stent group was better than PTCD group (χ2 = 6.280, P = 0.012). Conclusion: PTCD based on biliary stent implantation is an effective palliative treatment for patients with malignant biliary obstruction after failed ERCP, and the effect is superior to PTCD alone.