不同排布方式的胆道双支架治疗高位恶性梗阻性黄疸的疗效及安全性分析

Efficacy and safety of double biliary stents with different arrangements in the treatment of high malignant obstructive jaundice

目的 探讨经皮肝穿刺方法植入不同排布方式的胆道双支架在高位恶性梗阻性黄疸介入治疗中的疗效及安全性。方法 选取我院收治的90例高位恶性梗阻性黄疸患者,分析患者的临床资料,随访术后第1、4、12周的相关实验室检验结果及并发症情况,记录支架通畅时间、患者生存时间。结果 按照胆道支架排布方式,纳入Y型组43例,7型组47例。Y型组术后1周总胆红素与直接胆红素下降明显,较7型组快,差异有统计学意义(P <0.05);7型组术后1周白蛋白水平较术前明显上升,差异有统计学意义(P <0.05);Y型组的中位支架通畅时间明显长于7型组,差异有统计学意义(P <0.05)。两组的中位总生存期差异无统计学意义(P> 0.05)。结论 治疗高位恶性梗阻性黄疸,经皮肝穿刺方法植入胆道双支架植入安全可行,Y型胆道双支架排布方式支架通畅时间更长。

Objective To study the efficacy and safety of percutaneous hepatic puncture method implantation of different arrangement of biliary double stent in the interventional treatment of high-grade malignant obstructive jaundice.Methods We selected 90 patients with high malignant obstructive jaundice admitted in our hospital,analyzed of patients'clinical data,followed-up of relevant laboratory test results and complications at weeks 1,4 and 12 postoperatively,and recorded of stent patency time and patients'survival time.Results According to the arrangement of biliary stents,43 cases were in the Y-type group and 47 in the type-7 group.The total bilirubin and direct bilirubin in the Y-type group decreased significantly faster than that in the type-7 group at 1 week after surgery(P<0.05);The albumin level of type-7 group was significantly increased at 1 week after operation compared with that before operation(P<0.05),and the difference was statistically significant;The median stent patency time in the Y-type group was significantly longer than that in the type-7 group(P<0.05).There was no significant difference in the median overall survival between the two groups(P>0.05).Conclusion For the treatment of high-grade malignant obstructive jaundice,the percutaneous hepatic puncture method of biliary double stent implantation is safe and feasible,and the stent patency time is longer in the Y-type biliary double stent arrangement.