胆汁回输在经皮胆道支架置入术中的疗效分析

Analysis of the effect of bile reinfusion in percutaneous biliary stent implantation

目的探讨胆汁回输在经皮胆道支架置入术中的临床作用。方法选取2016年3月至2019年3月该院80例因恶性梗阻性黄疸行经皮胆道支架置入的患者作为研究对象,以40例进行胆汁回输的患者作为观察组,以未进行胆汁回输的40例患者作为对照组,两组患者住院当天完善必要检查,无明显禁忌后于入院第1天均行经皮肝穿刺胆道引流术,观察组患者于入院第2天进行胆汁回输至出院停止,分析两组患者在入院时及入院后第4天的总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、清蛋白(ALB)水平变化及住院时间、术后并发症情况。结果两组患者入院时ALT、AST、TBIL、DBIL、ALB水平比较,差异均无统计学意义(P>0.05),在入院后第4天(即胆汁回输第3天)两组患者ALT、AST、TBIL、DBIL水平均明显下降,且观察组患者ALT、AST、TBIL、DBIL水平较对照组下降更明显,差异均有统计学意义(P<0.05)。与入院时比较,在入院后第4天时,观察组患者ALB水平明显升高,对照组患者ALB水平明显下降,差异均有统计学意义(P<0.05);观察组患者经皮胆道支架置入术后并发症发生率除腹胀外,其余并发症与对照组比较,差异均有统计学意义(P<0.05);观察组患者住院时间短于对照组,差异有统计学意义(P<0.05)。结论胆汁回输可明显改善行经皮胆道支架置入术患者术前的肝功能状况,降低术后并发症发生率,并且可促进患者恢复。

Objective To investigate the clinical effect of bile reinfusion in percutaneous biliary stent implantation.Methods A total of 80 patients who underwent with percutaneous biliary stent implantation due to malignant obstructive jaundice in the hospital from March 2016 to March 2019 were selected as the study object.40 patients with bile reinfusion were taken as the observation group and 40 patients without bile reinfusion were taken as the control group.All patients completed the necessary examination on the day of hospitalization.Percutaneous transhepatic biliary drainage was performed on the first day after admission when without obvious contraindications,and the patients in the observation group received bile reinfusion on the second day after admission until they were discharged from hospital.The changes of total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and albumin(ALB)levels on the day of admission and on the fourth day after admission were analyzed in the two groups.Results There were no significant differences in ALT,AST,TBIL,DBIL and ALB levels between the two groups on admission(P>0.05).The levels of ALT,AST,TBIL and DBIL in the two groups decreased significantly on the 4th day after admission(the 3rd day after bile reinfusion),and the decreases of the levels of ALT,AST,TBIL and DBIL in the observation group were more obvious than those in the control group,and the differences were statistically significant(P<0.05).Compared with the day of admission,ALB level of the observation group was significantly higher on the 4th day after admission,ALB level in control group decreased significantly,and the differences were statistically significant(P<0.05).There were statistically significant difference in the incidence of postoperative complications in the observation group after bile reinfusion compared with that in the control group(P<0.05),except abdominal distention(P>0.05).The length of hospital stay in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05).Conclusion Bile reinfusion can significantly improve the liver function of patients undergoing percutaneous biliary stent implantation,reduce the incidence of postoperative complications,and promote the recovery of patients.