内镜超声下胆道引流在经内镜逆行胰胆管造影失败的恶性梗阻性黄疸中的价值  

Therapeutic value of endoscopic ultrasound.guided biliary drainage for malignant obstructive jaundice after failed endoscopic retrograde cholangiopancreatography

作　　者：黄平[1] 张筱凤[1] 吕文[1] 楼颂梅[1] 蒋楠[1] Huang Ping Zhang Xiaofeng Lyu Wen Lou Songmei Jiang Nan(Department of gastroenterology, The First People＇s Hospital of Hangzhou , Hangzhou 310006, China)

机构地区：[1]浙江省杭州市第一人民医院消化内科,310006

出　　处：《中华消化内镜杂志》2017年第4期246-249,共4页Chinese Journal of Digestive Endoscopy

基　　金：杭州市科技发展计划项目（20140733Q11）

摘　　要：目的探讨内镜超声下胆道引流（EUS—BD）在经内镜逆行胰胆管造影术（ERCP）失败的恶性梗阻性黄疸中的应用及价值。方法对2014年1月至2016年1月在杭州市第一人民医院住院期间行ERCP失败的恶性梗阻性黄疸患者根据抽签行EUS—BD（A组36例）及经皮经肝穿刺胆管引流（PTCD）治疗（B组30例），对比分析两组患者的操作成功率、肝功能指标恢复情况、并发症发生率、住院时间和住院费用。结果A组和B组患者操作成功率为分别为94．44％（34／36）、86．67％（26／30），差异无统计学意义（P〉0．05）；两组患者在肝功能恢复时间[（25．79±6．48）d比（30．24±8．49）d]、并发症发生率[5．56％（2／36）比23．33％（7／30）]、住院时间[（21．54±4．73）d比（25．68±8．56）d]和住院费用[（2．35±0．84）万元比（3．28±0．65）万元]方面相比，差异有统计学意义（P〈0．05）。结论内镜超声下胆道引流创伤小、疗效好，可作为ERCP失败的恶性梗阻性黄疸的首选治疗。Objective To study the therapeutic effect of EUS-guided biliary drainage （EUS-BD） on patients with malignant obstructive jaundice when ERCP failed. Methods From January 2014 to January 2016, all patients with malignant obstructive jaundice during hospitalization underwent EUS-guided biliary drainage （group A, 36 cases） or PTCD treatment （group B, 30 cases） by draw after failed ERCP. Operation success rate, liver function recovery time, complication rates, length of hospital stay and hospital costs were observed and compared. Results There was no significant difference in the operation success rates between two groups [94.44% （34/36） VS 86. 67% （26/30）, P〉0 05） ]. And there were significant differences in liver function recovery time （ 25.79 ± 6. 48 d VS 30. 24 ± 8.49 d）, incidence of complications [ 5.56% （2/36） VS 23.33% （7/30）], length of hospital stay （21.54±4.73 d VS 25.68 ± 8.56 d） and hospitalization costs （ 23.5±8.4 thousand yuan VS 32. 8±6. 5 thousand yuan, P〈0. 05）. Conclusion EUS- guided biliary drainage could be the first option for its noninvasiveness and efficacy, when ERCP failed in patients with malignant obstructive jaundice.

关 键 词：黄疸 阻塞性 内镜超声下胆道引流 经皮经肝穿刺胆道引流 

分 类 号：R730.5[医药卫生—肿瘤]