PTCD和ERCP在梗阻性黄疸治疗中的应用

Application of PTCD and ERCP in the treatment of obstructive jaundice

目的探讨PTCD和ERCP在梗阻性黄疸治疗中的应用。方法选取2014年1月~2016年12月我院收治的36例梗阻性黄疸患者作为研究对象,根据患者身体情况及自愿为原则,分为PTCD组和ERCP各18例。PTCD组采用经皮肝穿刺胆道引流术(PTCD)治疗,ERCP组采用内镜逆行胰胆管造影术(ERCP)治疗,对比两组患者的临床效果。结果治疗良性梗阻性黄疸时,ERCP组术后5 d血清总胆红素下降水平、并发症发生率优于PTCD组,差异有统计学意义(P<0.05);两组手术成功率差异无统计学意义(P>0.05)。在治疗恶性梗阻性黄疸时,PTCD手术成功率、术后5 d血清总胆红素水平优于ERCP组,差异有统计学意义(P<0.05);两组并发症发生率无明显差异(P>0.05)。结论 ERCP与PTCD均有其优势,临床可根据患者的实际情况合理选择,提高治疗的临床效果。

Objective To research the application of PTCD and ERCP in the treatment of obstructive jaundice.Methods 36 cases with obstructive jaundice in our hospital frmn January 2014 to December 2016 were selected as research objects and then they were divided into two groups according to physical conditions of patients and the principle of voluntariness,18 cases in each group.Treated with Percutaneous Transhepatic Choledochus Drainage （PTCD） in the PTCD group and treated with Endoscopic Retrograde Cholangiopancreatography （ERCP） in the ERCP group.The clinical ef- fects of patients were compared in pairs.Results In the treatment of benign obstructive jaundice, thedeclining level of 5 d serum total bilirubin and the complication occurring rate after operation in ERCP group were better than that in the PTCD group, the difference between the two groups was statistically significant （P〈0.05）.The operative success rates of two groups had no significant differences （P〉0.05）.In the treatment of malignant obstructive jaundice, the operative success rate and declining level of 5 d serum total bilirubin atter operation in PTCD group were better than ERCP group, the differencc between the two groups was statistically significant （P〈0.05）.The complication occurring rates of two groups had no significant differences （P〉0.05）.Conclusion ERCP and PTCD have their own advantages.In the clinical treatment, the reasonable choice should be made based on the actual conditimls of patients to improve the clinical effects of treathen