经皮肝穿刺胆道支架植入治疗恶性梗阻性黄疸的早期疗效  

The early effect of percutaneous transhepatic biliary stenting on malignant obstructive jaundice

作　　者：张汉意 翁杰锋[1] 张帅[1] 黄子圣 王文[1] 李佩霖 陈国东 古维立[1] ZHANG Han-yi;WENG Jie-feng;ZHANG Shuai;HUANG Zi-sheng;WANG Wen;LI Pei-lin;CHEN Guo-dong;GU Wei-li(Department of General Surgery,Guangzhou First People's Hospital,Guangzhou Medical University,Guangzhou 510180,Guangdong,China)

机构地区：[1]广州医科大学附属广州市第一人民医院普通外科,广东广州510180 [2]广州医科大学附属广州市第一人民医院介入科,广东广州510180

出　　处：《广东医学》2019年第12期1732-1736,共5页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2011B061300024,2013B021800057);广州市医药卫生科技一般引导项目(编号:20171A011248,20181A011002);广州市中医药科技项目(编号:20172A011004)

摘　　要：目的研究"一步法"和"两步法"经皮肝穿刺胆道支架植入术治疗恶性梗阻性黄疸的早期疗效。方法收集111例诊断为恶性梗阻性黄疸且接受过经皮肝穿刺胆道支架植入术治疗患者的临床资料进行回顾性分析。结果两种方法均能使患者黄疸减轻,肝功能好转,"一步法"和"两步法"有效引流率分别为64.8%和80%,早期并发症发生率分别为34.1%和30%,早期不良事件发生率分别为35.2%和30%,平均住院时间分别为(19.8±7.2)d和(24.6±10.5)d,平均住院费用分别为(72 916±21 137)元和(88 010±19 843)元。结论"一步法"和"两步法"经皮肝穿刺胆道支架植入术都是治疗恶性梗阻性黄疸的有效方法,早期疗效相当,但"一步法"住院时间和费用较"两步法"少,既可减轻患者经济负担,又能提高医疗资源利用效率,在临床治疗中值得优先选择。Objective To evaluate the early efficacy and safety of one-step and two-step percutaneous transhepatic biliary stenting on malignant obstructive jaundice. Methods Clinical data of 111 patients with malignant obstructive jaundice who received percutaneous transhepatic biliary stenting between January 2013 and July 2007 in our institute was collected. Results Both of the two methods effectively reduced jaundice and improved liver function. The effective drainage rate was 64.8% in the one-step group and 80% in the two-step group. The rates of early complications were 34.1% and 30%, respectively. The of early adverse event rates were 35.2% and 30%, respectively. The hospital stays were 19.8 days and 24.6 days, respectively. The costs were 72 916 RMB and 88 010 RMB, respectively. Conclusion Both one-step and two-step percutaneous transhepatic biliary stenting are effective on malignant obstructive jaundice. The early efficacy and safety of two methods are similar. However, compared with two-step method, one-step is more cost-effective with shorter hospital stay.

关 键 词：经皮肝穿刺胆道支架植入术 恶性梗阻性黄疸 早期疗效 

分 类 号：R657.4[医药卫生—外科学] R608[医药卫生—临床医学]