阻塞性黄疸术前经皮肝穿刺胆管引流对围手术期的影响  

Effect of preoperative percutaneous transhepatic cholangic drainage in perioperative treatment of obstructive jaundice

作　　者：缪锦超 刘赞伟 施珊格 蔡世春 黄家荣 

机构地区：[1]海丰县彭湃纪念医院普外科,广东汕尾516400

出　　处：《岭南现代临床外科》2014年第1期76-79,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的总结阻塞性黄疸术前经皮肝穿刺胆管引流对围手术期的影响及应用经验。方法选取86例阻塞性黄疸患者,依据手术方法分为两组,44例给予经皮肝穿刺胆管引流后根治术治疗者为观察组,42例给予内外引流术或根治术治疗者为对照组,比较术中出血量、手术时间、住院时间及并发症发生率,术前和术后14 d时肝功能指标总胆红素(TB)、血清谷丙转氨酶(ALT)、谷草转氨酶(AST)变化。结果观察组手术时间、出血量、住院时间及并发症发生率均低于对照组(P<0.05),两组患者入院时TB、ALT、AST水平比较差异无统计学意义(P>0.05),术后14 d时TB、ALT、AST均明显下降,与治疗前组内比较差异具有统计学意义(P<0.05),观察组术后14 d与对照组组术后14 d血浆TB、ALT、AST比较下降更为明显(P<0.05)。结论阻塞性黄疸术前给予经皮肝穿刺导管引流,可有效缩短住院时间、降低治疗费用及手术并发症,且可有效改善肝功能,从而提高手术治疗疗效。Objective To summarize the experience in treatment of the obstructive jaundice by preoperative percutaneous puncture of liver bile duct drainage. Methods Eight-six patients with obstructive jaundice were included and divided into two groups according to the operation procedure, 44 cases were given preoperative percutaneous transhepatic cholangial drainage （observation group） and then, underwent internal or external drainage or radical operation, 42 cases were served as control group without preoperative percutaneous transhepatic cholangial drainage. Intraoperative blood loss, operative time, hospital stay and comphcations were compared between two groups. The preoperative and postoperative liver function tests, such as total bilirubin （TB）, serum alanine aminotransferase （ALT）, aspartate aminotransferase （AST） were evaluated and compared in two groups. Results The operation time, blood loss, length of hospital stay and complication rates between observation group were lower than that in control group （P〈0.05）. The levels of TB, ALT, AST in 14 days after operation reduced in two groups, but were significantly decreased in observation group, as compared to control group （P〈0.05）. Conclusion For patients with obstructive jaundice, preoperative percutaneous transhepatic cholangial drainage would shorten the length of hospital stay, reduce complications occurrence, and improve liver function.

关 键 词：阻塞性黄疸 经皮肝穿刺胆管引流 围手术期 

分 类 号：R657.4[医药卫生—外科学]