非金属胆道支架内引流治疗急性梗阻性化脓性胆管炎35例临床分析

Non-metal biliary tents drainage in the management of acute obstructive suppurative cholangitis(35 cases)

目的评价非金属胆道支架内引流治疗急性梗阻性化脓性胆管炎的疗效。方法回顾性分析经非金属胆道支架内引流治疗的35例AOSC患者的临床资料,其胆管梗阻原因为单纯肝外胆管结石30例,恶性肿瘤导致梗阻4例,胆道术后良性狭窄1例,在综合治疗基础上,通过十二指肠镜行非金属胆道支架内引流进行胆道减压。结果 35例均成功放置胆道支架,术后无急性胰腺炎、胆道穿孔、十二指肠穿孔、出血等重大并发症发生,行非金属胆道支架置入引流后5天,血白细胞总数、血清总红素、直接胆红素、酶学指标均显著下降。结论非金属胆道支架内引流作为一种AOSC治疗手段,具有创伤轻、住院时间缩短、患者痛苦减少、符合现代医学治疗微创发展方向的优势,是一种安全有效的胆道引流方法 。

Objective To evaluate the efficacy of non-metal biliary tents drainage in the management of acute obstructive suppurative cholangitis（AOSC）. Methods There were 30 biliary lithiasis patients, four malignant biliary tumor patients and one narrowing bileduct patient in all 35 patie nts. All the patients during the procedure were firstly examined with endoscopic retrograde cholangiopancreatogarpy（ERCP）,and then placed non-metal biliary tents in bileduct. Results Thirtyfive patients were all successfully embedded with non-metal biliary tents. There were no severe complications such as acute pancreatitis, perforated bileduct and duodenal wall, haemorrhage. The total and direct bilirubin,white blood cell and transaminase enzymes in all patients dropped significantly after biliary drainage. Conclusion Non-metal biliary tents drainage in the management of acute obstructive suppurative cholangitis is a safe and effective procedure.