不同途径胆道金属支架置入治疗不同类型恶性阻塞性黄疸的临床对比研究

Comparative Research on Different Ways of Metal Biliary Stent Placement in Treatment of Different Types of Malignant Obstructive Jaundice

目的对比不同途径胆道金属支架置入治疗不同类型恶性阻塞性黄疸的临床效果。方法方便选取2011年1月—2015年10月在该院行胆道金属支架置入治疗的MOJ患者150例,其中经ERCP途径50例(ERCP组),经PTCD途径100例(PTCD组)。对比两组的手术成功率、有效率、术后并发症发生率、住院时间。结果高位梗阻中ERCP组有效率明显低于PTCD组,差异具有统计学意义(P<0.05);ERCP组总并发症发生率明显低于PTCD组,差异具有统计学意义(P<0.05);低位梗阻中和ERCP组并发症发生率低于PTCD组,差异具有统计学意义(P<0.05)。结论经ERCP和经PTCD途径胆道金属支架置入治疗MOJ均可取得显著的临床疗效,对于低位梗阻患者而言经ERCP更有优势,对于高位梗阻患者而言经PTCD途径更有优势。

Objective To compare the clinical effects of different ways of metal biliary stent placement in treatment of different types of malignant obstructive jaundice. Methods 150 cases of MOJ patients receiving metal biliary stent placement in our hospital from January 2011 to October 2015 were selected, 50 cases were through the ERCP way（ERCP group）, 100 cases were through the PTCD way（PTCD group）, and the successful rates and effective rates, incidence rates of postoperative complications and lengths of stay were compared between the two groups. Results The difference in the successful rate of operation for low obstruction between the two groups was not statistically significant, P〉0.05, the successful rate of operation for high obstruction in the ERCP group was obviously lower than that in the PTCD group, and the difference was statistically significant,P〈0.05. The difference in the total effective rate between the two groups was not statistically significant,P〉0.05, the successful rate of operation for high obstruction in the ERCP group was obviously lower than that in the PTCD group, and the difference was statistically significant, P〈0.05. The incidence rate of complications in the ERCP group was obviously lower than that in the PTCD group, and the difference was statistically significant, P〈0.05, the incidence rate of complications of high obstruction in the ERCP group was obviously higher than that in the PTCD group, and the difference was statistically significant, P〈0.05. The difference in the length of stay had statistical significance between the two groups,P 〈0.05. Conclusion The metal biliary stent placement through the ERCP way and PTCD way in treatment of MOJ can obtain an obvious clinical curative effect, and the ERCP way is more advantageous for patients with low obstruction, and the PTCD way is more advantageous for patients with high obstruction.