对恶性肝门部胆管梗阻用自膨式金属内支架与内镜逆行胆管内引流疗效对比

The comparison of therapeutic effect using expandable metallic biliary endorosthesis and endoscopic retrobiliary drainage in patients of mallignant hilar biliary obstruction.

本文回顾性地对比分析了采用自膨式金属内支架术（ＥＭＢＥ）和经内镜逆行胆管内引流术（ＥＲＢＤ）对２０例恶性肝门部胆管梗阻（ＭＨＢＯ）病人的治疗情况。结果：有效减黄率：在ＥＲＢＤ和ＥＭＢＥ组分别为７７．８％和８８．９％；早期合并胆管炎发生率：ＥＲＢＤ和ＥＭＢＥ分别为５５．６％和１１．２％（Ｐ＜０．００１）；支架梗阻和／或晚期胆管炎发生率两组分别为６６．６％和３７．４％（Ｐ＜０．０１）；两组平均生存期分别为：１５９±７６和２５４±８４天（Ｐ＜０．０１）。结论：ＥＭＢＥ治疗ＭＨＢＯ较ＥＲＢＤ疗效好，早期胆管炎发生率低，支架不易阻塞，生存质量高。

his paper retrospectively analysed and evaluated 20 patients with malignant hilar biliar obstruction (MHBO) in comparison with expandable metallic biliary endoprosthese (EMBE) and ERBD.Results:Complete drainage were achived the rate of relief jundics:ERBD and EMBE was 77.8% and 88.9% Separately.The rate of early complication of cholangitis:ERBD and EMBE was 55.6% and 11.2% separately (P<0.001).The rate of reobstruction:ERBD and EMBE was 66.6% and 37.4% separately (P<0.01).The mean survial days:ERBD and EMBE was 159±76 and 254±84days (P<0.01).Conclusion:The effects of EMBE is better than ERBD in treating MHBO,the rate of early complication of cholangitis the EMBE is better than ERBD in treating MHBO,is lower.Long standing patency of stent and reduced reobstruction,improved quality of life.