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作 者:刘勇[1] 纪艳超[2] 孙岩岩[2] 陈曦海[2] 庄丽维[1]
机构地区:[1]哈尔滨医科大学附属第四医院消化内科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第四医院普外科,黑龙江哈尔滨150001
出 处:《胃肠病学和肝病学杂志》2010年第12期1139-1141,共3页Chinese Journal of Gastroenterology and Hepatology
摘 要:目的探讨经内镜内置塑管引流术(endoscopic retrograde biliary drainage,ERBD)和自膨记忆钛镍合金金属支架引流术(endoscopic metal biliary endoprothesis,EMBE)在恶性梗阻性黄疸疾病治疗中的疗效。方法收集我院2005年3月~2010年3月间确诊的恶性梗阻性黄疸患者51例,全部患者均成功行内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ER-CP),分别行ERBD和EMBE治疗。比较治疗前、后的胆红素变化情况;随访观察支架再堵塞率和支架平均引流时间。结果ERBD组17例患者中14例发生了支架堵塞或移位,再堵塞率为82.35%,支架平均引流时间为(71.2±40.6)d。EMBE组34例患者中3例堵塞支架,再堵塞率为8.82%,支架平均引流时间为(189.6±59.8)d。EMBE组的再堵塞率明显小于ERBD组,其差异具有显著统计学意义(P〈0.05);EMBE组平均引流时间明显长于ERBD组,其差异也具有显著统计学意义(P〈0.05)。结论内镜检查及治疗可以较清晰显示胆道梗阻原因及病变范围,EMBE具有较低的再堵塞率和较长的引流时间,对于治疗晚期无法手术的胆道梗阻患者,是一种安全、微创、有效的姑息性治疗手段。Objective To explore the efficacy of endoscopic retrograde biliary drainage(ERBD) and endoscopic metal biliary endoprothesis(EMBE) in the treatment of malignant obstructive jaundice.Methods Fifty-one patients with malignant obstructive jaundice diagnosed from March 2005 to March 2010 in our hospital were collected.Endoscopic retrograde cholangio pancreatography were successfully performed in all patients.ERBD or EMBE was also conducted.Bilirubin before and after treatment were compared.Stent re-blockage rate and average drainage time were followed up.Results Stent blockage or displacement occurred in 14 of 17 patients in ERBD group.The re-blockage rate was 82.35% and the average drainage time was(71.2±40.6) d.Stent blockage occurred in 3 of 34 patients in EMBE group.The re-blockage rate was 8.82% and the average drainage time was(189.6±59.8) d.The re-blockage rate was significantly lower in EMBE group than in ERBD group.The average drainage time was significantly longer in EMBE group than in ERBD group.Conclusion The endoscopic examination and treatment clearly show the causes and extent of biliary obstruction.EMBE has a lower re-blockage rate and a longer average drainage time,EMBE is a safe,minimally invasive and effective palliative method in the treatment of advanced inoperable patients with biliary obstruction.
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