内镜下胆管内支架引流对恶性阻塞性黄疸内毒素血症影响的临床研究  

EFFECTS OF ENDOSCOPIC BILIARY DRAINAGE ON THE ENDOTOXDEMIA IN PATIENTS WITH MALIGNANT OBSTRUCTIVE JAUNDICE

作　　者：薛平[1] 胡以则[1] 卢海武[1] 尹巧群[1] 张端[1] 

机构地区：[1]广州医学院第二附属医院肝胆外科

出　　处：《中国内镜杂志》1998年第6期6-8,共3页China Journal of Endoscopy

摘　　要：目的：研究探讨内镜下胆管内支架引流术对恶性阻塞性黄疸患者血浆中内毒素含量的影响及临床意义。方法：选择１６例恶性阻塞性黄疸为治疗组，１０例胆囊结石为对照组，观察其术前、后血中内毒素含量、ＴＮＦ及肠道细菌数的变化。结果恶性阻塞性黄疸组术前内毒素水平较正常对照组明显升高，经内镜下胆道内支架引流后，恶性阻塞性黄疸病人的内毒素血症、ＴＮＦ较术前得到有效降低，肠道细菌数减少。ＥＲＢＤ术后无严重并发症发生，减黄满意率８０％。结论：恶性阻塞性黄疸病人存在严重内毒血症，内镜下胆管内引流术能在短时间内有效解除高内毒素血症，是一种创伤小、并发症少、有效的治疗手段。Object:To investigate the effects of endoscopic biliary drainage on the endotoxdemia in the patients with malignant obstructive jaundice.Method:Changes of plasma endotoxin,tumor necrosis factor(TNF),and the bacteria amount in the gut were observed in 16 cases of malignant obstructive jaundice (treatment group) and 10 cases of gallbladder stone as a control group.Results:The content of the endotoxine in malignant obstructive jaundice was obviously higher than that of normals.After biliary drainage by endoscopy,the level of plasmic endotoxin,TNF,and the bacteria amount in malignant obstructive jaundice significantly decreased.There were no severe postoperative complications with endoscopic biliary drainage.Conclusion:the patients with malignant obstructive jaundice has severe endotoxdemia,Endoscopic biliary drainage can reduce the level of endotoxine in plasma,relieve the endotoxdemia in the short time.It is a minimally invasive and effective procedure.

关 键 词：梗阻性黄疸 内镜 胆管内支架 引流 内毒素血症 

分 类 号：R657.406[医药卫生—外科学] R631.305[医药卫生—临床医学]