内镜下鼻胆管引流术与经皮肝穿刺胆道引流治疗急性梗阻性化脓性胆管炎疗效  

Effect of Endoscopic Nasobiliary Drainage and Percutaneous Transhepatic Biliary Drainage in the Treatment of Acute Obstructive Suppurative Cholangitis

作　　者：马长林[1] 王利培[2] 乔森[1] 孙瑞杰[1] 巩芬[3] 刘建刚[1] 李一春[1] 

机构地区：[1]山东省济宁市第一人民医院肝胆外科,山东济宁272011 [2]山东省济宁市第一人民医院新生儿监护室,山东济宁272011 [3]山东省济宁市第一人民医院普外科,山东济宁272011

出　　处：《现代生物医学进展》2015年第9期1728-1731,共4页Progress in Modern Biomedicine

基　　金：山东省济宁市科技局医学计划项目(2012jnwk14)

摘　　要：目的:探讨内镜下鼻胆管引流术与经皮肝穿刺胆道引流治疗急性梗阻性化脓性胆管炎的疗效。方法:选择我院335例急性梗阻性化脓性胆管炎患者,按不同治疗方法分为A、B、C三组,A组125例患者使用传统胆管切开并T管引流术,B组100例患者使用内镜下鼻胆管引流术治疗,C组110例患者使用经皮肝穿刺胆道引流治疗。比较三组患者治疗有效率、脓性胆汁引流量、术后1周血清胆红素水平、住院时间及并发症发生率。结果:B、C组患者治疗有效率分别为91.0%(91/100)及90.9%(100/110),明显高于A组71.2%(89/125),B组与C组治疗有效率比较差异无统计学意义(P>0.05);B、C组脓性胆汁引流量、术后1周血清胆红素水平及住院时间均优于A组,比较差异具有统计学意义(P<0.05),B组与C组以上指标比较差异无统计学意义(P>0.05);B、C组并发症发生率分别为11.0%(11/100)和8.2%(9/110),均明显低于A组的28.0%(35/125),比较差异具有统计学意义(P<0.05)。结论:内镜下鼻胆管引流术与经皮肝穿刺胆道引流治疗急性梗阻性化脓性胆管炎疗效均明显优于传统开放手术,且术后并发症少,值得推广应用。Objective： To study the effect of endoscopic nasobiliary drainage and percutaneous transhepatic biliary drainage in the treatment of acute obstructive suppurative cholangitis. Methods： 335 cases of patients with acute obstructive suppurative cholangitis in our hospital were divided into group A, B,C according to different treatment methods, group A of 125 cases of patients used traditional common bile duct and T tube drainage, group B of 100 cases of patients used endoscopic nasobiliary drainage, and group C of 110 cases of patients used percutaneous transhepatic biliary drainage. The curative effect, purulent bile drainage, serum bilirubin level of 1 week after treatment, hospitalization time and complication rate of the three groups were compared. Results： The total effective rate of group B and group C were 91.0% （91/100） and 90.9% （100/110）, significantly higher than 71.2% （89/125） of group A, the difference was statistically significant （P〈0.05）, there was no significant difference in the effective rate between group B and group C （P〉0.05）. The purulent bile drainage volume, postoperative serum bilirubin level of 1 week after treamtent, and hospitalization time of group B and group C were better than those of group A,with significant difference （P〈0.05）, there was no significant difference between group B and group C （P〉0.05）; The complication rate of group B and group C were 11.0%（11/100） and 8.2%（9/110）, significantly lower than 28.0% （35/125） of group A, with significant difference （P〈0.05）. Conclusion： The effect of endoscopic nasobiliary drainage and percutaneous transhepatic biliary drainage is obviously superior than the traditional open operation in the treatment of acute obstructive suppurative cholangitis, with less postoperative complications, it is worthy of popularization and application.

关 键 词：内镜 鼻胆管 经皮肝穿刺 引流 急性梗阻性化脓性胆管炎 

分 类 号：R657.45[医药卫生—外科学]