经皮肝穿刺胆道引流术治疗高位恶性梗阻性黄疸对患者肝功能的影响分析  

Analysis of the effect of PTCD treatment of high MOJ on liver function of patient

作　　者：李海文 杨河 李萌 LI Hai-wen;YANG He;LI Meng(Ultrasound Department,Qionghai People's Hospital,Qionghai 571400,China;不详)

机构地区：[1]琼海市人民医院超声科,海南琼海571400 [2]琼海市人民医院肝胆外科,海南琼海571400 [3]浙江省肿瘤医院超声介入科,浙江杭州310022

出　　处：《中国医学装备》2021年第5期109-112,共4页China Medical Equipment

基　　金：海南省自然科学基金(817332)“经皮肝穿刺胆道引流(PTCD)术治疗高位恶性梗阻性黄疸对患者肝功能的研究”。

摘　　要：目的:探讨经皮肝穿刺胆管引流(PTCD)术治疗高位恶性梗阻性黄疸(MOJ)的效果及对肝功能的影响。方法:选取医院肝胆外科收治的92例高位MOJ患者,按照治疗方式不同将其分为对照组和观察组,每组46例。对照组采用经内镜逆行胰胆管造影(ERCP)治疗,观察组采用PTCD术治疗,对比两组患者临床治疗的有效性及肝功能变化情况,并对比两种术式的安全性。结果:观察组治疗总有效率为95.65%,略高于对照组的86.96%,组间比较差异无统计学意义;相较于术前,术后1周时两组患者总胆红素(TBIL)、直接胆红素(DBIL)、天门冬氨酸氨基转移酶(AST)及谷氨酰转肽酶(GGT)等指标均显著下降,且观察组指标均低于对照组,差异有统计学意义(t=3.024,t=2.841,t=3.005,t=2.257;P<0.05);观察组患者术后并发症发生率略高于对照组,但组间差异无统计学意义。两组患者术后随访5~9个月,中位随访时间为7个月,观察组患者生存率高于对照组,差异有统计学意义(χ^(2)=4.156,P<0.05)。结论:PTCD治疗MOJ的效果佳,对患者肝功能有更好的改善作用,可降低术后安全风险,提升近中期生存率。Objective:To investigate the effect of percutaneous transhepatic cholangial drainage(PTCD)in treating high malignant obstructive jaundice(MOJ)and its influence on liver function.Methods:92 patients with high MOJ admitted to hospital were selected.They were divided into control group(n=46 cases)underwent endoscopic retrograde cholangiopancreatography(ERCP)treatment and observation group(n=46 cases)underwent PTCD treatment according to different treatment methods.The effectiveness and liver function changes of clinical treatment of two groups were compared,and the safeties of the two kinds of surgical procedures were further compared.Results:The total effective rate of the treatment in observation group was 95.65%,which was slightly higher than 86.96%in control group,while there was no significant difference in that between the two groups.Compared with the preoperative period,the series of indicators included total bilirubin(TBIL),direct bilirubin(DBIL),aspartate aminotransferase(AST)and glutamyl transpeptidase(GGT)at 1 week post operation decreased significantly,and these indicators of observation group were significantly lower than those of control group(t=3.024,t=2.841,t=3.005,t=2.257,P<0.05).The incidence of postoperative complications in observation group was slightly higher than that of control group,while there was no significant difference in that between the groups.The patients both two groups were followed up for 5-9 months after the operation(the median follow-up time was 7 months),and the survival rate of observation group was significantly higher than that of control group,and the difference of that between the two groups was statistically significant.(χ^(2)=4.156,P<0.05).Conclusion:The effect PTCD is excellent in treating MOJ,and it has better effect on improving liver function of patients,and it can reduce the safety risk post operation,and it can increase the survival rate of approximate mid-range.

关 键 词：恶性梗阻性黄疸(MOJ) 引流术 肝功能 安全性 

分 类 号：R442.4[医药卫生—诊断学]