经皮胆管穿刺引流介入对肝门部胆管癌患者肝功能恢复、肿瘤标志物及血清MMP-9的影响

The Effect of Percutaneous Cholangiopuncture and Drainage Intervention on Liver Function Recovery,Tumor Markers,and Serum MMP-9 in Patients with Hilar Cholangiocarcinoma

目的经皮胆管穿刺引流介入对肝门部胆管癌患者肝功能恢复、肿瘤标志物及血清基质金属蛋白酶9(MMP-9)的影响。方法选择2019年8月至2022年8月安阳市肿瘤医院收治的79例肝门部胆管癌患者,随机分为对照组(39例)和研究组(40例)。给予对照组患者经内镜鼻胆管引流治疗,给予研究组患者经皮胆管穿刺引流介入治疗。将两组患者临床相关指标,治疗前后肝功能指标,血清肿瘤标志物指标、MMP-9水平,以及术后并发症总发生情况进行对比。结果两组患者手术时间、术中出血量、术后住院时间、并发症总发生率等进行对比,无差异(均P>0.05);相较于治疗前,治疗后两组患者总胆红素(TBi L)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)均下降,且研究组患者TBi L、AST水平均比对照组低(均P<0.05);治疗后两组患者癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原50(CA50)、MMP-9均相较于治疗前下降,且研究组均比对照组低(均P<0.05)。结论相较于经内镜鼻胆管引流,经皮胆管穿刺引流介入治疗应用肝门胆管癌患者的治疗中,可有助于肝功能的恢复,降低血清肿瘤标志物水平及MMP-9水平,且不会增加并发症的发生。

Objective To investigate the effects of percutaneous cholangiopuncture and drainage intervention on liver function recovery,tumor markers,and serum matrix metalloproteinase-9(MMP-9)in patients with hilar cholangiocarcinoma.Method 79 patients with hilar cholangiocarcinoma admitted to Anyang Cancer Hospital from August 2019 to August 2022 were randomly divided into a control group(39 cases)and a study group(40 cases).Patients in the control group were given endoscopic nasobiliary drainage treatment,while patients in the study group were given percutaneous cholangiopuncture drainage intervention treatment.Compare clinical related indicators,liver function indicators before and after treatment,serum tumor marker indicators,MMP-9 levels,and total incidence of postoperative complications between two groups of patients.Results There was no difference in the surgical time,intraoperative blood loss,postoperative hospital stay,and total incidence of complications between the two groups of patients(all P>0.05);Compared to before treatment,after treatment,the total bilirubin(TBiL),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in both groups of patients decreased,and the levels of TBiL and AST in the study group were lower than those in the control group(both P<0.05);After treatment,the levels of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),carbohydrate antigen 50(CA50),and MMP-9 in both groups of patients decreased compared to before treatment,and the study group was lower than the control group(all P<0.05).Conclusion Compared with endoscopic nasobiliary drainage,percutaneous cholangiopuncture and drainage intervention in the treatment of patients with hilar cholangiocarcinoma can help restore liver function,reduce serum tumor marker levels and MMP-9 levels,and do not increase the incidence of complications.