恶性梗阻性黄疸经胆管引流术与胆管支架置入术治疗疗效观察

Study on the Clinical Effects of Percuteneous Transhepatic Cholangio Drainage and Percuteneous Transhepatic Biliary Stenting in the Treatment of Malignant Obstructive Jaundice

目的:探讨经皮肝穿刺胆道引流术(PTCD)与胆管支架置入术治疗恶性阻塞性黄疸临床疗效差异。方法:回顾分析石河子市人民医院2014年1月至2018年1月收治的PTCD或胆管支架置入治疗完整资料的62例恶性梗阻性黄疸患者,比较两组患者的手术成功率、黄疸改善情况、术后并发症的发生率、平均生存时间。结果:PTCD手术组成功率较支架置入组高;两组患者术后1周降黄效果均明显;PTCD术后并发症发生率较支架置入组低;支架置入术组患者生存时间较PTCD明显延长。结论:PTCD组与支架置入组退黄效果明显,对于晚期梗阻黄疸患者,PTCD治疗具有治疗效果好、手术成功率高、术后严重并发症发生率低等优势,因此对于晚期胆道梗阻的患者,首先推荐选择PTCD相关治疗;对于一般条件较好患者,支架置入治疗具有生存时间长的优势。

Objective:To investigate the clinical effect of(percuteneous transhepatic cholangio drainage,PTCD)and biliary stenting in the treatment of malignant obstructive jaundice.Methods:Retrospective analysis of 62 patients with malignant obstructive jaundice who underwent complete treatment of PTCD or biliary stent placement from January 2014 to January 2018 in Shihezi People’s Hospital.Compared the patient’s success rate,improvement of jaundice and postoperative complications Incidence,average survival time.Results:The power of PTCD surgery was higher than that of the stent group;the two groups had obvious yellowing effect at 1 week after operation.The incidence of postoperative complications of PTCD was lower than that of the stented group.The survival time of patients in the stent placement group was significantly longer than that of PTCD.Conclusion:The PTCD group and the stent placement group had obvious yellowing effect.For patients with advanced obstruction jaundice,PTCD treatment has the advantages of good therapeutic effect,high success rate of surgery,and low incidence of serious complications.Therefore,for patients with advanced biliary obstruction,first it is recommended to choose PTCD-related treatment;for patients with better general conditions,stent placement has the advantage of long survival time.