经内镜下逆行胰胆管造影置入支架治疗恶性胆管梗阻的临床研究  

Clinical research of ERCP biliary stent placement for treating the patients with malignant biliary obstruction

作　　者：沈建伟[1] 张立明[1] 贾晓伟[1] 

机构地区：[1]天津市第五中心医院肝胆外科,天津300450

出　　处：《中国内镜杂志》2013年第2期180-183,共4页China Journal of Endoscopy

摘　　要：目的探讨内镜下逆行胰胆管造影(ERCP)置入支架治疗恶性胆管梗阻的临床效果。方法回顾性分析2008年8月～2011年2月该院收治的60例恶性胆管梗阻患者的临床资料,60例患者按治疗方式分为胆管支架置入组(支架组,32例)和外科姑息手术组(常规组,28例),常规组患者给予常规外科姑息手术治疗,支架组患者给予经ERCP胆管支架置入术治疗。检测两组患者术前及术后1周肝功能水平,并观察并发症发生情况,随访观察患者生存时间。结果支架组均成功完成支架置入治疗,成功率为100%。手术治疗后,两组肝功能均明显改善,肝功能(TB、ALT、AST、ALP、GGT)水平与术前比较均显著降低,相比较差异均有显著性(均P<0.05);且术后支架组肝功能(TB、ALT、AST、ALP、GGT)水平与对照组比较显著降低,相比较差异均有显著性(均P<0.05);支架组术后并发症发生率为15.6%,常规组为50.0%,相比较差异有显著性(P<0.05);两组术后生存率和平均生存时间比较差异均无显著性(均P>0.05)。结论经ERCP下置入支架优于传统手术,是治疗恶性胆管梗阻的一种较好的方法,手术成功率高,并发症少,值得临床应用。[Objective] To investigate the clinical effects of endoscopic retrograde cholangiopancreatography （ERCP） biliary stent placement for treating the patients with malignant biliary obstruction. [Methods] The clinical data of 60 cases with malignant biliary obstruction was retrospectively analyzed from August 2008 to February 2011. 60 patients were divided into two groups by surgical treatment, the biliary stent placement （stent group, 32 cases） and surgical palliation groups （conventional group, 28 cases）. The conventional group was treated with conventional surgical palliative surgery, stent group was treated by ERCP biliary stent placement. The liver function levels of the two groups in preoperative and postoperative 1 week were detected, the occurrence of complications was observed, ant the survival time of patients was recorded in the follow-up period. [Results] The stent group＇s patients were successful stent placement, the success rate was 100%. After surgery, the liver function of the two groups were significantly improved, the liver function （TB, ALT, AST, ALP, GGT） were significantly lower compared with the preoperative levels, the different was significant （P 0.05）, and the liver function （TB, ALT, AST, ALP, GGT） levels of the stent group was significantly reduced compared with the conventional group levels, the different was significant （P 0.05）; The rate of postoperative complication of stent group was 15.6%, the conventional group was 50.0%, the compared the different was significant （P 0.05）; The postoperative survival rate and average survival time were no significant difference in the two groups （P 0.05）. [Conclusion] The ERCP biliary stent placement is superior to traditional surgery, and it is a better method for treating the patients with malignant biliary obstruction. The surgical has high success rate and fewer complications, it is worthy of clinical application.

关 键 词：内镜 ERCP 恶性胆管梗阻 胆管支架 外科姑息手术 

分 类 号：R735.8[医药卫生—肿瘤]