三种姑息性减黄术治疗恶性胆道梗阻的疗效评价  

Efficacy evaluation of three kinds of palliative jaundice reduction therapy for malignant biliary obstruction

作　　者：王君超 陈永忠[1] 仝亚林[1] Wang Junchao Chen Yongzhong Tong Yalin(Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第一附属医院消化内一科,450052

出　　处：《中国实用医刊》2017年第18期15-18,共4页Chinese Journal of Practical Medicine

基　　金：2011年河南省科技厅基础资助项目（112300410029）

摘　　要：目的比较三种姑息性减黄术治疗恶性胆道梗阻的临床疗效。方法193例未能行根治性手术切除的恶性胆道梗阻患者按内镜下胆管内支架植入引流术（ERBD）、经皮肝穿刺胆道引流术（PTCD）和姑息性胆肠吻合术三种治疗方法分成ERBD组62例、PTCD组71例和胆肠吻合组60例，对三组患者肝功能指标、术后近期并发症、住院时间和生存时间进行回顾性分析。结果三组术后肝功能、生存时间比较差异未见统计学意义（P〉0．05）。ERBD组较胆肠吻合组住院时间、术后近期并发症明显减少。PTCD组较胆肠组住院时间明显缩短、术后近期并发症明显减少。ERBD组较PTCD组术后近期并发症减少。结论ERBD是治疗恶性胆道梗阻安全有效的方法，其具有创伤小、效果好、并发症少和应用广泛等优点，对于丧失行根治性手术的患者为首选方法，值得临养广泛推广，duction surgery on Objective To compare the clinical efficacy of three kinds of palliative jaundice re- malignant biliary obstruction. Methods one hundred and ninety - three patients with malignant biliary obstruction failed to undergo radical resection were selected, according to endoscopic drainage （ERBD）, percutaneous transhepatic biliary drainage （PTCD） and palliative biliary enteric anastomosis, they were divided into ERBD group （n = 62）, PTCD group （n = 71 ）and choledochojejunosto- my group（ n = 60）. The liver function, postoperative complications, hospitalization time and survival time were retrospectively analyzed. Results There was no significant difference in the change of jaundice or hepatic functions, survival time among the three groups （P 〉 0. 05 ）. The patients in ERBD group had shorter hospital stay and less postoperative complications compared with the patoents in cholangioenterostomy group. The patients in PTCI） group had shorter hospital stay and less postoperative complications compared with the patients in cholangioenterostomy group. The patients in ERBD group had less postoperative complications compared with the patients in PTCD group. Conclusions ERBD in treatment of malignant biliary obstruction is safe and effective, with less trauma, less complication and good effect, and has the advantages of small trauma, good effect, less complication and wide application, and it is the preferred method for the patients who lose the radical operation, so it is worth popularizing widely in clinics.

关 键 词：姑息性减黄术 恶性胆道梗阻 内镜下胆管内支架植入引流术 经皮肝穿刺胆道引流术 胆肠吻合术 

分 类 号：R657.4[医药卫生—外科学]