复方苦参注射液联合PTCD胆道支架置入术治疗恶性梗阻性黄疸的临床观察

Clinical Study of Compound Kushen Injection with Ercutaneous Transhepatic Biliary Stent Implantation in Treatment of Malignant Biliary Obstruction

目的：探讨复方苦参注射液联合PTCD胆道支架置入术治疗恶性梗阻性黄疸的临床疗效。方法：选取2014年7月—2017年7月在本科接受PTCD胆道支架置入术的恶性梗阻性黄疸患者46例,随机分为治疗组及对照组各23例,对照组给予PTCD胆道支架置入术,治疗组在对照组基础上加用复方苦参注射液,观察治疗前后两组肝功能、黄疸改善情况及术后3个月两组患者胆道通畅情况。结果：术后5 d,对照组ALT、DBIL较治疗前下降,差异有统计学意义,治疗组ALT、TBIL、DBIL较治疗前下降,差异具有统计学意义,治疗组TBIL、DBIL较对照组下降更为明显;术后4周,对照组及治疗组AST、ALT、TBIL、DBIL、IBIL较术前均明显下降,且术后4周,治疗组DBIL较对照组下降更明显,差异具有统计学意义;治疗后治疗组较对照组黄疸缓解更明显,且术后3个月,治疗组较对照组胆道更为通畅。结论：复方苦参注射液配合PTCD胆道支架置入术能有效改善肝功能及术后黄疸缓解情况,较单纯PTCD胆道支架置入术更能减低再梗阻风险,值得临床推广。

Objective： To investigate the clinical efficacy of Compound Kushen Injection with ercutaneous transhepatic biliary stent implantation in the treatment of malignant biliary obstruction. Methods： Forty-sixpatients with malignant biliary obstruction who received ercutaneous transhepatic biliary stent implantationin our hospital from July 2014 to July 2017 were randomly divided into treatment group and control group with 23 cases in each group. The control group was treated with PTCD biliary stent implantation and the treatment group was treated with Compound Kushen Injection on the basis of the control group. The liver function and jaundice improvement of the two groups were observed before and after the treatment. Three months after operation,the patency of biliary tract was observed in two groups. Results： Five days after the operation,ALT and DBIL in the control group decreased and ALT,TBIL and DBIL in the treatment group decreased. TBIL and DBIL in the treatment group decreased more significantly compared to those of the control group. Four weeks after operation,AST,ALT,TBIL,DBIL and IBIL in the control group and treatment group were significantly lower than those before operation,and after 4 weeks,DBIL in the treatment group decreased more significantly than that in the control group,and the difference was statistically significant. After treatment,the jaundice remission in treatment group was more obvious than that in control group. Three months after operation,the biliary tract in treatment group was more unobstructed than that in control group. Conclusion： Compound Kushen Injection combined with PTCD biliary stent implantation can effectively improve liver function and postoperative jaundice relief,which can reduce the risk of obstruction compared with simple PTCD biliary stent implantation,which is worthy of clinical promotion.