肝门部胆管癌患者术前减黄治疗的近期疗效  

The effect of percutaneous transhepatic biliary drainage before operation on patients with hilar cholangiocarcinoma

作　　者：张树亮[1] 刁美霞 

机构地区：[1]山东省淄博市临淄区人民医院肝胆外科,淄博255400 [2]山东省淄博市临淄区人民医院产科,淄博255400

出　　处：《中国肿瘤临床与康复》2014年第2期169-171,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨术前减黄治疗对肝门部胆管癌手术近期效果的影响。方法选取40例行肝切除手术的肝门部胆管癌患者,随机分为观察组(20例)和对照组(20例)。观察组患者在手术前给予经皮经肝胆管引流(PTBD)的减黄治疗,而对照组患者则直接进行手术治疗,比较分析观察组患者的肝功能改变情况以及两组患者手术相关指标的变化情况。结果观察组患者给予减黄治疗前后的总胆红素水平分别为(317.2±134.1)μmol/L和(152.3±67.6)μmol/L,差异有统计学意义(P<0.05)。观察组患者术中出血量明显高于对照组患者(P<0.05)。观察组和对照组的术后并发症发生率差异无统计学意义(P>0.05)。结论肝门部胆管癌患者术前减黄治疗可在一定程度上改善患者的胆红素水平和身体状态。采用术前减黄治疗应综合考虑各个因素,对于术前血胆红素水平明显升高或身体较差的患者,则可适当考虑术前减黄治疗。Objective We aim to investigate the effect of percutaneous transhepatic biliary drain- age （PTBD） before operation on patients with hilar cholangiocarcinoma. Methods 40 patients who suffer hilar cholangiocarcinoma were divided into the observation group and the control group randomly. 20 patients in observation group receiving PTBD treatment and the other patients in control group receiving surgery di- rectly. The changes of liver function of patients in observation group and the indications related to the opera- tion of patients in both groups were compared and analyzed. Results The total bilirubin of patients in the observation group was （317.2 ±134. 1 ） μmol/L before PTBD treatment, which has been significantly re- duced to （ 152. 3 ±67. 6）μmol/L after treatment （P 〈 0. 05 ）. The bleeding volume of patients in observa- tion group was （1014± 921 ） mL, which is significantly higher than that of patients in the control group, and the difference between two groups was statistically significant（P 〈0. 05 ）. Also there was no significant difference of postoperative complications between the two groups in the incidence（P 〉0. 05 ）. Conclusions The PTBD treatment can improve the patient＇s bilirubin level and physical condition. Whether the patient should receive PTBD treatment before operation needs overall consideration. The patients with high preoper- ative serum bilirubin levels or have poor physical condition are appropriate and considerable to be given the PTBD treatment before operation.

关 键 词：肝门部胆管癌 经皮经肝胆管引流 治疗效果 

分 类 号：R735.8[医药卫生—肿瘤]