经内镜胆道支架置入术治疗恶性胆道梗阻的临床研究  

Clinical study of endoscopic biliary stent placement in the treatment of malignant biliary obstruction

作　　者：卢天有 吴天文 潘维来 谭彬斯 LU Tianyou;WU Tianwen;PAN Weilai;TAN Binsi(General Surgery Department,Luoding People's Hospital,Luoding 527200,China)

机构地区：[1]罗定市人民医院普外科,广东罗定527200

出　　处：《临床医学研究与实践》2023年第9期5-8,共4页Clinical Research and Practice

基　　金：云浮市医药卫生科技计划项目(No.WS202012)。

摘　　要：目的分析经内镜胆道支架置入术治疗恶性胆道梗阻的临床效果。方法选取我院2014年1月至2018年12月收治的34例恶性胆道梗阻患者作为经皮经肝胆道引流术(PTCD)组(行PTCD治疗),同时选取我院2020年7月至2023年2月收治的30例恶性胆道梗阻患者作为支架组(行经内镜胆道支架置入术治疗)。比较两组的治疗效果。结果支架组的治疗总有效率明显高于PTCD组,差异具有统计学意义(P<0.05)。支架组的并发症总发生率明显低于PTCD组,差异具有统计学意义(P<0.05)。术后,支架组的肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、间接胆红素(IBIL)]、疼痛介质[β-内咖肽(β-EP)、神经肽Y(NPY)]及应激指标[去甲肾上腺素(NE)、皮质醇(Cor)、C肽(CP)]明显低于PTCD组,营养指标[白蛋白(ALB)、血红蛋白(HB)、总蛋白(TP)]明显高于PTCD组,差异具有统计学意义(P<0.05)。结论经内镜胆道支架置入术治疗恶性胆道梗阻的临床效果显著,安全性较高,可促进肝功能改善,且对患者的应激刺激较小。Objective To analyze the clinical effect of endoscopic biliary stent placement in the treatment of malignant biliary obstruction.Methods A total of 34 patients with malignant biliary obstruction admitted in our hospital from January 2014 to December 2018 were selected as percutaneous transhepatic cholangial drainage(PTCD)group(treated with PTCD),and 30 patients with malignant biliary obstruction admitted in our hospital from July 2020 to February 2023 were selected as stent group(treated with endoscopic biliary stent placement).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the stent group was significantly higher than that in the PTCD group,and the difference was statistically significant(P<0.05).The total incidence of complications in the stent group was significantly lower than that in the PTCD group,and the difference was statistically significant(P<0.05).After operation,the liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),indirect bilirubin(IBIL)],pain mediators[β-endocaffein(β-EP),neuropeptide Y(NPY)]and stress indexes[epinephrine(NE),cortisol(Cor),C-peptide(CP)]in the stent group were significantly lower than those in the PTCD group,the nutritional indexes[albumin(ALB),hemoglobin(HB),total protein(TP)]were significantly higher than those in the PTCD group,and the differences were statistically significant(P<0.05).Conclusion Endoscopic biliary stent placement in the treatment of malignant biliary obstruction has a significant clinical effect and high safety,which can promote the improvement of liver function and has less stress stimulation to patients.

关 键 词：恶性胆道梗阻 经内镜胆道支架置入术 经皮经肝胆道引流术 

分 类 号：R739.41[医药卫生—肿瘤]