ERCP途径与PTCD途径胆道金属支架置入术治疗恶性阻塞性黄疸患者的效果比较  

Comparison of effects of ERCP and PTCD biliary metal stent implantation in treatment of patients with malignant obstructive jaundice

作　　者：淡绪国 DAN Xuguo(Department of Intervention of Dengzhou People’s Hospital,Dengzhou 474150 Henan,China)

机构地区：[1]邓州市人民医院介入科,河南邓州474150

出　　处：《中国民康医学》2021年第14期116-118,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较经内镜逆行胰胆管造影术(ERCP)途径与经皮肝穿刺胆道引流术(PTCD)途径胆道金属支架置入术治疗恶性阻塞性黄疸患者的效果。方法:回顾性分析2017年5月至2020年4月该院收治的62例行胆道金属支架置入术的恶性阻塞性黄疸患者的临床资料,根据不同置入途径分为对照组(n=30)与观察组(n=32)。对照组行PTCD胆道金属支架置入术,观察组行ERCP胆道金属支架置入术,比较两组营养指标[血清白蛋白(ALB)、总蛋白(TP)、转铁蛋白(TRF)]水平、肝功能指标[总胆红素(TBIL)、直接胆红素(DBIL)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)]水平和并发症发生率。结果:术后,两组ALB、TP、TRF水平均高于术前,且观察组明显高于对照组,差异有统计学意义(P<0.05);术后,两组TBIL、DBIL、ALP和ALT水平均低于术前,且观察组明显低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:ERCP途径胆道金属支架置入术治疗恶性阻塞性黄疸患者可提高营养指标水平,以及降低肝功能指标水平,效果优于PTCD途径胆道金属支架置入术。Objective:To compare effects of biliary metal stent implantation through endoscopic retrograde cholangiopancreatography(ERCP)and percutaneous transhepatic cholangial drainage(PTCD)in treatment of patients with malignant obstructive jaundice.Methods:A retrospective analysis of the clinical data of 62 patients with malignant obstructive jaundice who underwent biliary metal stent placement in the hospital from May 2017 to April 2020 was performed.According to different implantation methods,they were divided into control group(n=30)and observation group(n=32).The control group underwent PTCD biliary metal stent implantation,while the observation group underwent ERCP biliary metal stent implantation.The nutritional indicator[serum albumin(ALB),total protein(TP),transferrin(TRF)]levels,the liver function indicator[total bilirubin(TBIL),direct bilirubin(DBIL),alkaline phosphatase(ALP),alanine aminotransferase(ALT)]levels and complication rate were compared between the two groups.Results:After the surgery,the levels of ALB,TP,and TRF in the two groups were higher than those before the surgery;those of the observation group were significantly higher than those of the control group;and the differences were statistically significant(P<0.05).After the surgery,the levels of TBIL,DBIL,ALP and ALT in the two groups were lower than those before the surgery;those of the observation group were significantly lower than those of the control group;and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:The biliary metal stent implantation through the ERCP approach in the treatment of the patients with malignant obstructive jaundice can increase the levels of nutritional indicators and reduce the levels of liver function indicators.Moreover,it is superior to the biliary metal stent implantation through the PTCD approach.

关 键 词：恶性阻塞性黄疸 经内镜逆行胰胆管造影术 经皮肝穿刺胆道引流术 胆道金属支架 营养指标 肝功能 并发症 

分 类 号：R735[医药卫生—肿瘤]