胆管癌根治术与PTBD术对胆管癌患者应激反应及治疗效果的影响

The effects of radical cholangiocarcinoma surgery and PTBD on the stress reaction and therapeutic effect of cholangiocarcinoma(CCA)patients

目的探究对胆管癌根治术与经皮经肝胆道引流(PTBD)对胆管癌(CCA)患者应激反应及治疗效果的影响.方法回顾性选取2022年1月-2023年12月87名在山东省威海市立医院接受治疗的CCA患者按照不同手术方式分为对照组(n=42,PTBD术)与观察组(n=45,胆管癌根治术),检测并评估两组研究对象的治疗效果、应激反应以及肝功能指标的变化.结果对照组治疗总有效率显著低于观察组(71.43%VS88.89%),差异有统计学意义(P<0.05);治疗前两组患者收缩压(SBP)、舒张压(DBP)、心率(HR)指标组间无明显差异,P>0.05,治疗后与对照组相比,观察组应激反应水平显著较高,P<0.05;治疗前与对照组相比,观察组总胆红素(TBil)、谷草转氨酶(AST)、谷丙转氨酶(ALT)水平无明显差异(P>0.05),治疗后与对照组相比,观察组肝功能指标显著较低,P<0.05.结论对于CCA患者采用胆管癌根治术进行治疗效果较好,该手术视野清晰操作精准性高,给患者带来生存希望,虽存在一定的应激反应,但术后患者肝功能恢复指标较好,值得临床应用推广.

Objective To investigate the effects of radical cholangiocarcinoma surgery and percutaneous transhepatic biliary drainage(PTBD)on the stress response and therapeutic effect of cholangiocarcinoma(CCA)patients.Methods Eighty-seven CCA patients treated in our hospital from January 2022 to December 2023 were retrospectively selected and divided into the control group(n=42,PTBD)and the observation group(n=45,radical cholangiocarcinoma surgery)according to different surgical modalities,and the therapeutic efficacy,stress reaction,and changes in liver function indexes were detected and evaluated in the two study groups.Results The treatment efficiency of the control group was significantly lower than that of the observation group(71.43%vs.88.89%),and the difference was statistically significant(P<0.05);there was no difference in the indicators of systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)between the two groups of patients before treatment,with a P>0.05,and the level of stress reaction of the observation group was significantly higher compared with the control group,with a P<0.05.Compared with the control group before treatment,there was no difference in the levels of total bilirubin(TBil),glutamic transaminase(AST)and alanine aminotransferase(ALT)in the observation group(P>0.05),and compared with the control group after treatment,the liver function indexes of the observation group were significantly lower,with P<0.05.Conclusion The effect of radical cholangiocarcinoma surgery is better in the treatment of patients with CCA,and the surgery has clear field of vision with high precision,which brings hope of survival for the patients.The operation has a clear vision and high precision,which brings hope for the patients’survival.Although there is a certain stress reaction,the patients’liver function recovery indexes are better after the operation,which is worthy of clinical application and promotion.