经皮经肝穿刺胆管引流术与经内镜鼻胆管引流术对肝门部胆管癌的治疗效果分析

Comparison of Percutaneous Transhepatic Biliary Drainage and Endoscopic Nasobiliary Drainage in the Treatment of Hilar Cholangiocarcinoma

目的探讨经皮经肝穿刺胆管引流术(PTCD)与经内镜鼻胆管引流术(ENBD)对肝门部胆管癌(HCCA)的治疗效果。方法选择HCCA患者为研究对象,按随机数字表法将84例患者分为两组,各42例。对照组行ENBD,观察组行PTCD,两组均随访1周。对比两组手术效果、肝功能及并发症发生情况。结果观察组术后胆汁引流量为(366.78±31.79)ml,多于对照组的(334.59±30.36)ml,差异有统计学意义(P<0.05);观察组术后血清碱性磷酸酶(ALP)、总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)及总胆红素(TB)水平分别为(177.73±29.79)U/L、(37.72±5.20)μmol/L、(32.05±4.32)U/L、(112.24±20.79)μmol/L,均低于对照组的(195.86±32.05)U/L、(42.46±6.95)μmol/L、(37.74±5.59)U/L、(121.26±20.21)μmol/L,差异均有统计学意义(P<0.05);观察组并发症发生率(4.76%)低于对照组(19.05%),差异有统计学意义(P<0.05)。结论相较于ENDB,PTCD在HCCA治疗中效果更佳,术后胆汁引流量更多,利于改善患者肝功能,减少并发症的发生。

Objective To investigate the therapeutic effects of percutaneous transhepatic cholangiodrainage(PTCD)and endoscopic nasobiliary drainage(ENBD)on hilar cholangiocarcinoma(HCCA).Methods 84 patients with HCCA were divided into 2 groups according to random number table,42 patients in each group.The control group received ENBD and the observation group received PTCD.Both groups were followed up for 1 week.The operation effect,liver function and complications were compared between the 2 groups.Results The postoperative bile drainage volume of the observation group was(366.78±31.79)ml,which was significantly higher than that of the control group(334.59±30.36)ml(P<0.05);The levels of serum alkaline phosphatase(ALP),total bile acid(TBA),alanine aminotransferase(ALT)and total bilirubin(TB)in the observation group were(177.73±29.79)U/L and(37.72±5.20)respectivelyμmol/L、(32.05±4.32)U/L、(112.24±20.79)μMol/L,lower than(195.86±32.05)U/L,(42.46±6.95)of the control groupμmol/L、(37.74±5.59)U/L、(121.26±20.21)μMol/L,the difference was statistically significant(P<0.05);The incidence of complications in the observation group(4.76%)was lower than that in the control group(19.05%),and the difference was statistically significant(P<0.05).Conclusion Compared with ENDB,PTCD is more effective in the treatment of HCCA,with more bile drainage after operation,which is beneficial to improve the liver function of patients and reduce the occurrence of complications.