经皮经肝胆管穿刺置管引流联合介入治疗老年恶性梗阻性黄疸的效果分析

Effect of Percutaneous Transhepatic Bile Duct Drainage Combined with Interventional Therapy for Malignant Obstructive Jaundice in Elderly Patients

目的探究老年恶性梗阻性黄疸患者接受经皮经肝胆穿刺置管引流与介入联合治疗的价值。方法方便选取老年恶性梗阻性黄疸患者100例,时间选取为2015年1月—2017年12月,以计算机随机化法分组,其中对照组接受经皮经肝胆穿刺置管引流治疗,实验组则同时联合介入术治疗,对比两组老年恶性梗阻性黄疸患者治疗结果的差异。结果实验组老年恶性梗阻性黄疸患者治疗后的直接胆红素(29.34±27.33)μmol/L、总胆红素水平(55.23±34.24)μmol/L以及住院时间(10.85±5.31)d均明显低于对照组(直接胆红素相比,t=2.864 8,P=0.005 1;总胆红素相比,t=2.614 8,P=0.010 3;住院时间相比,t=6.552 0,P=0.000 1);实验组患者并发症的几率(4.00%)与对照组并发症几率(8.00%)相比,差异无统计学意义(χ~2=0.709 2,P=0.400)。结论老年恶性梗阻性黄疸患者接受经皮经肝胆穿刺置管引流与介入术联合治疗,可有效降低其胆红素水平,缩短其康复的时间,且不会增加其出现并发症的几率,意义重大。

Objective To investigate the value of percutaneous transhepatic biliary drainage and interventional therapy in patients with malignant obstructive jaundice. Methods One hundred patients with malignant obstructive jaundice were convenient selected. The time was from January 2015 to December 2017. The patients were divided into two groups according to computerized randomization. The control group received pereutaneous transhepatie biliary drainage and the experimental group was combined the interventional therapy, to compare the differences in treatment outcomes between the two groups of elderly patients with malignant obstructive jaundice. Results The direct bilirubin （29.34±27.33）μmol/L, total bilirubin level （55.23±34.24）μmol/L and hospitalization time （10.85±5.31） d were significantly lower in the elderly patients with malignant obstructive jaundice in the control group （direct bilirubin, t=2.864 8, P=0.005 1; total bilirubin compared, t=2.614 8,P= 0.010 3; compared with hospital stay, t=6.552 0,P=0.000 1）; The odds of complications in the experimental group （4.00%） were not statistically significant compared with the control group （8.00%） （X^2=0.709 2, P=0.400）. Conclusion Patients with malignant obstructive jaundice undergoing pereutaneous transhepatie biliary drainage and interventional therapy can effectively reduce the level of bilirubin and shorten the recovery time without increasing the chance of complications.