恶性梗阻性黄疸经超声引导经皮肝穿刺胆道引流治疗的安全性及疗效分析

Safety and efficacy of ultrasound-guided percutaneous transhepatic biliary drainage treatment of malignant obstructive jaundice

目的：分析经皮肝穿刺胆道引流术（PTBD）治疗恶性梗阻性黄疸患者的临床疗效及预后。方法：回顾分析安康市中心医院2009年4月~2014年2月收治的恶性梗阻性黄疸患者共112例,将所有患者随机分为对照组（42例）与观察组（70例）,其中对照组患者接受开腹手术引流治疗,观察组患者则接受PTBD介入治疗。对所有患者进行3~23个月的随访,观察、统计两组患者接受不同治疗方法后的临床疗效、并发症情况以及住院时间,并对结果进行比对分析。结果：两组患者接受不同治疗之后,血清中AIL、AST、TBIL和DBIL水平均较治疗前下降,但观察组患者血清中AIL、AST、TBIL、DBIL水平低于对照组（P〈0.05）。两组患者WBC水平和NE水平均较治疗前下降（P〈0.05）,但治疗后两组间比较,WBC、NE和PT指标差异均无统计学意义（P〉0.05）。并且观察组患者的不良反应发生率与住院时间均少于对照组（P〈0.05）。结论：介入治疗能够改善恶性梗阻性黄疸患者临床症状,降低不良反应发生率,减少住院时间,是不能手术切除的恶性梗阻性黄疸治疗的首选方法,值得临床推广。

Objective：To study the clinical effect and prognosis of percutaneous transhepatic biliary drainage （PTBD） treatment of patients with malignant obstructive jaundice.Methods：A total of 1 12 patients with malignant obstructive jaundice treated in our hospital from April 2009 to February 2014 were retrospectively analyzed.All patients were randomly divided into control group （42 cases）and observation group （70 cases）,control group received drainage of laparotomy and observation group received PTBD intervention.All patients were followed up for 3 to 23 months.Clinical effect,complication and length of stay were observed and counted after two groups received different treatment,and the results were compared and analyzed.Re-sults：After two groups received different treatment,serum AIL,AST,TBIL and DBIL levels significantly decreased than be-fore treatment,but serum AIL,AST,TBIL and DBIL levels of observation group were lower than those of control group （P〈0.05）.The levels of WBC and NE of both groups were lower than before treatment （P 〈0.05）,but differences in WBC,NE and PT between the two groups were not statistical significant after treatment （P 〉0.05）.Meanwhile,the incidence of adversenbsp;reaction and length of stay of observation group were lower than those of control group （P〈0.05）.Conclusions：Interventional treatment of malignant obstructive jaundice can effectively improve the clinical symptoms,reduce incidence of adverse reactions and shorten the length of stay,which is the preferred method for medically inoperable malignant obstructive jaundice and worth clinical popularization.