经皮胆道支架置入与姑息性胆肠内引流对胰头癌所致梗阻性黄疸的疗效观察

Curative effect study of percutaneous biliary stent implantation and palliative biliary drainage treating obstructive jaundice

目的探讨经皮胆道支架置入(PTCD)对胰头癌所致梗阻性黄疸的疗效。方法对该院74例胰头癌晚期患者的临床资料进行回顾性分析。比较PTCD和姑息性胆肠内引流的疗效。结果观察组和对照组术后2周肝功能均明显好转,胆道梗阻情况均明显改善,差异有显著统计学意义(均P<0.05)。观察组患者术后2周肝功能明显好于对照组,差异有统计学意义(P<0.05);但两组胆道梗阻情况比较差异无统计学意义(P>0.05)。两组患者术中均未发生死亡事件,两组患者皮肤黄疸、瘙痒情况均逐渐消退或缓解、减轻。观察组患者住院时间和术中出血量少于对照组,差异有统计学意义(P<0.05)。两组患者并发症发生率比较,差异无统计学意义(18.42%vs 13.89%,P>0.05)。两组患者术后生存时间比较差异无统计学意义(9.28±6.51)月vs(8.96±5.28)月,P>0.05。结论对病情严重、身体状况较差、失去手术切除机会的胰头癌患者采用PTCD途径支架置入,不仅可有效解除患者胆道梗阻症状,且方便、安全、创伤小。

Objective To study the curative effect of percutaneous biliary stent implantation treating obstructive jaundice.Methods Clinical data of 74 patients with advanced pancreatic head carcinoma treated in The Affiliated Hospital of Wuhan University were retro-spectively analyzed.The curative effects of PTCD and palliative biliary enteral drainage were compared.Results After two weeks liver functions of observation group and control group were significantly improved,and biliary obstruction was also significantly improved,with significant difference （P〈0.05）.Two weeks after the operation liver function of patients in observation group was significantly better than the control group,with statistically significant difference （P〈0.05）;But the biliary obstruction situation was similar between the two groups and had no statistical significance （P〉0.05）.There were no death reports in patients in two groups.Jaudice and skin itch-ing of patients in both groups also faded or were relieved.Hospital stay and intraoperative blood loss of patients in observation group were less than the control group,and the difference was statistically significant （P〈0.05）.Complications of patients in two groups were not significantly different （18.42%vs 13.89%,P〉0.05）.There was no statistically significant difference in postoperative survival time of patients between the two groups （9.28 ±6.51 months vs 8.96 ±5.28 months,P〉0.05）.Conclusions Treating patients with pancreatic head carcinoma who are seriously ill with poor physical condition and have lost the chance of operation by using the method of PTCD can not only effectively relieve symptoms of patients with biliary obstruction but also have the advantages of convenience,safety and minor trauma.