微创胆道引流对肝门部胆管癌的临床疗效及预后  

Clinical Efficacy and Prognosis of Minimally Invasive Biliary Drainage for Hilar Cholangiocarcinoma

作　　者：秦亚鹏 商中华 QIN Yapeng;SHANG Zhonghua(Second Hospital of Shanxi Medical University,Taiyuan,030000)

机构地区：[1]山西医科大学第二临床医学院,山西医科大学第二医院,030000

出　　处：《实用癌症杂志》2020年第7期1149-1152,共4页The Practical Journal of Cancer

基　　金：山西省自然科学基金项目(编号:201801D22111429040400095853729327)。

摘　　要：目的研究经皮经肝胆道引流术(PTCD)与内镜胆管金属支架引流术(EMBE)两种微创胆道引流方法在肝门部胆管癌(HCCA)治疗中的临床疗效及预后。方法回顾性分析收治的93例不宜行根治性或姑息性手术切除治疗的HCCA患者作为研究对象纳入本研究,其中45例为EMBE治疗,48例为PTCD治疗。结果PTCD与EMBE两种微创胆道引流成功率相比较,差异具有统计学意义(P<0.05);PTCD和EMBE两种微创胆道引流术后肝功能指标较术前明显改善,差异具有统计学意义(P<0.05),但PTCD与EMBE两种引流方式相比较,术前、术后肝功能指标差异无统计学意义(P>0.05);PTCD与EMBE两种微创胆道引流术后并发症总发生率相比,差异无统计学意义(P>0.05);肝门部胆管癌患者采用PTCD与EMBE两种微创胆道引流,对患者生存时间的差异无统计学意义(P>0.05)。结论对临床无法根治性或姑息性手术切除的肝门部胆管癌患者,采用PTCD或EMBE微创胆道引流能有效改善患者的肝功能,临床治疗效果值得肯定。PTCD与EMBE两种微创胆道引流术对患者预后生存时间疗效相当。Objective To study the clinical efficacy and prognosis of percutaneous transhepatic biliary drainage(PTCD and endoscopic metal biliary endoprosthesis(EMBE)in the treatment of hilar cholangiocarcinoma(HCCA).Methods Retrospective analysis of 93 HCCA patients who were not suitable for radical or palliative surgical resection were conducted,among which 45 were treated with EMBE and 48 with PTCD.Results The success rate of PTCD and EMBE was statistically significant(P<0.05).Liver function indexes after PTCD and EMBE minimally invasive biliary drainage were significantly improved compared with those before surgery,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in liver function indexes between PTCD and EMBE before and after surgery(P>0.05).There was no significant difference in the overall incidence of complications after PTCD and EMBE minimally invasive biliary drainage(P>0.05).PTCD and EMBE were used for minimally invasive biliary drainage in patients with hilar cholangiocarcinoma,and the difference in survival time was not statistically significant(P>0.05).Conclusion PTCD or EMBE minimally invasive biliary drainage can effectively improve the liver function of patients with hilar cholangiocarcinoma who cannot be clinically removed by radical or palliative surgery,and the clinical treatment effect is worthy of affirmation.PTCD and EMBE are 2 minimally invasive biliary drainage procedures with similar survival time.

关 键 词：微创胆道引流 肝门部胆管癌 经皮经肝胆道引流术 内镜胆管金属支架引流术 

分 类 号：R735.8[医药卫生—肿瘤]