经皮经肝穿刺胆管引流术在肝门部胆管癌治疗中的近期效果分析

Analysis of recent effect of percutaneous transhepatic cholangiodrainage for hilar cholangiocarcinoma

目的分析探讨经皮经肝穿刺胆管引流术在肝门部胆管癌治疗中的效果及对肝功能的影响。方法选择2012年2月至2016年2月该院不宜行早期手术治疗且总胆红素大于340μmol/L的102例肝门部胆管癌患者作为研究对象,其中50例行经皮经肝穿刺胆管引流术治疗(观察组),另外52例行经内镜鼻胆管引流术治疗(对照组)。观察、比较两组患者引流成功率、胆汁引流量、治疗前后肝功能指标变化情况及并发症发生情况。结果经相应治疗后,观察组患者引流成功率为86.0%,明显高于对照组的67.3%,组间比较差异有统计学意义(P<0.05);两组患者在胆汁引流量方面比较差异无统计学意义(P>0.05);两组患者治疗后肝功能指标均较治疗前明显下降,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);两组患者并发症发生率比较差异无统计学意义(P>0.05)。结论肝门部胆管癌应用经皮经肝穿刺胆管引流术治疗能够获得良好的效果,有效改善其肝功能,是一种安全、有效的治疗方法,值得临床推广应用。

Objective To analyze and investigate the effect of percutaneous transhepatic cholangio drainage on the treatment of hilar cholangiocarcinoma and its influence on liver function.Methods From February 2012 to February 2016,102 patients with hilar cholangiocarcinoma who were not suitable for operation and whose total bilirubin was greater than 340μmol/L were selected as the research subjects.Among them,50 cases were treated by percutaneous transhepatic cholangio drainage（observation group）,and 52 were treated by endoscopic naso biliary drainage（control group）.The drainage success rate,bile drainage volume,changes of liver function indexes and complications were observed and compared between the two groups.Results After the corresponding treatment,the successful rate of drainage in the observation group was 86.0 %,which was significantly better than 67.3%in the control group and there was a statistically significance between the groups（P〈0.05）.In the terms of bile drainage,there was no statistically significance between the two groups（P〈0.05）.After treatment,the liver function indexes of the two groups were significantly lower than those before the treatment,and the difference was statistically significant（P〈0.05）,but there were no statistically significance between the two groups（P〈0.05）.In the terms of the complication rate,there was no statistically significance between the two groups（P〈0.05）.Conclusion The application of percutaneous transhepatic biliary drainage in the treatment of hilar cholangiocarcinoma can achieve some good clinical results,effectively improve the liver function of patients,and it is also safe and reliable,which makes it worthy of promotion.