经皮肝穿刺胆道支架置放术治疗恶性胆道梗阻性黄疸的临床效果研究

Study on the clinical effect of cutaneous hepatic bilious s tent implantation for treatment of malignant bilious obstructive jaundice

目的研究皮肝穿刺胆道支架置放术治疗恶性胆道梗阻性黄疸的临床疗效。方法选取2013年2月至2015年2月在我院接受治疗的恶性胆道梗阻性黄疸患者共计52例,以双盲法随机分为观察组与对照组,对观察组采取皮肝穿刺胆道支架置放术治疗,对照组则采取经皮肝胆管外引流术治疗,比较两组治疗效果。结果采取PTIBS治疗的观察组在黄疸改善中的显效率为92.3%,尽管稍高于对照组的88.5%,但是差异无统计学意义(P>0.05),另外平均生存期高于对照组,并发症出现率低于对照组,两组差异有统计学意义(P<0.05)。治疗前,两组血清白蛋白差异无统计学意义(P>0.05);治疗后,观察组血清白蛋白为(34.8±4.0)g/L,对照组为(28.5±3.1)g/L,差异有统计学意义(P<0.05)。治疗后观察组血清总胆红素、直接胆红素、丙氨酸氨基转移酶、碱性磷酸酶均明显低于对照组(P<0.05)。结论 PTIBS能够有效改善黄疸,提高患者的生存期,并有效降低并发症的出现,具有较高的临床应用价值。

Objective To study the clinical efficacy of cutaneous hepatic bilious s tent implantation for treatment of malignant bilious obstructive jaundice. Methods In February 2013 to 2015 years 2 months in our hospital accepted treatment of malignant bilious obstruction jaundice in patients with a total of 52 cases,with double blind method were randomly divided into observation group and control group. In the observation group by cutaneous hepatic bilious s tent placement in the treatment of,the control group is taken by cutaneous electroencephalographic drainage in the treatment,compared two groups of treatment effect. Results The effective rate of PTIBS treatment in the observation group was 92. 3%,although slightly higher than the control group,but the difference was not statistically significant( P < 0. 05),and the average survival period was higher than the control group,the incidence of complications was lower than the control group,the difference between the two groups was statistically significant( P < 0. 05). Before treatment,there was no significant difference between the two groups( P > 0. 05); after treatment,the serum albumin was( 34. 8 ± 4) g / L,and the control group was( 28. 5 ± 3. 1) g / L,the difference was statistically significant( P < 0. 05). After treatment,serum total bilingual,direct bilingual,Alan transferal and alkaline phosphorescent in the observation group were significantly lower than those in the control group( P < 0. 05). Conclusion PTIBS can effectively improve the jaundice,improve the survival of patients,and effectively reduce the incidence of complications,and has a high clinical application value.