恶性梗阻性黄疸经皮肝穿刺胆道外引流与内外引流对照研究  

External and internal-external percutaneous transhepatic biliary drainage for patients with malignant obstructive jaundice:a control study

作　　者：谭中宝[1] 毛学群[1] 张建[1] 邹容[1] 王庆庆[1] 狄镇海[1] TAN Zhongbao;MAO Xuequn;ZHANG Jian;ZOU Rong;WANG Qingqing;DI Zhenhai(Department of Interventional Radiology,the Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu Province 212001,China)

机构地区：[1]江苏大学附属医院介入放射科,江苏镇江212001

出　　处：《实用放射学杂志》2023年第7期1166-1169,共4页Journal of Practical Radiology

摘　　要：目的 探讨经皮肝穿刺胆道外引流与内外引流治疗恶性梗阻性黄疸(MOJ)临床效果与并发症.方法 回顾性分析69例MOJ患者病历资料,根据引流方式分为外引流组和内外引流组.主要观察指标为临床效果与并发症.所有数据采用R统计学软件(4.1.0版)和R Studio进行统计学分析.结果 2组手术成功率均为100%.术后2组胆红素均较术前明显降低(P<0.05);术后胆红素、谷丙转氨酶和谷草转氨酶下降程度2组比较均无明显统计学差异(P>0.05).术后外引流组胆道感染及高淀粉酶血症发生率低于内外引流组(P<0.05),而电解质紊乱发生率高于内外引流组(P<0.05).结论 经皮肝穿刺胆道外引流与内外引流治疗MOJ均能起到较好临床效果,相比较内外引流,胆道外引流的并发症更少.Objective To compare the clinical effects and complications between external and internal-external percutaneous transhepatic biliary drainage(PTBD)for patients with malignant obstructive jaundice(MOJ).Methods Patients with MOJ who underwent external or internal-external PTBD were analyzed retrospectively.According to the different ways of biliary drainage,69 patients were divided into two groups:external drainage group and internal-external drainage group.The primary outcome measures were clinical effects and complications.All data were analyzed using R Statistical software(version 4.1.0)and R Studio.Results The success rate of operation was 1oo%in each group.Postoperative bilirubin levels were significantly lower compared to preoperative values in each group(P<0.05).There were no significant differences in the decreases of the levels of bilirubin,glutamic-pyruvic transaminase and glutamic oxaloacetic transaminase between the two groups(P>0.05).Patients in the external drainage group had a lower frequency of biliary infection and hyperamylasemia(P<0.05),and a higher frequency of electrolyte disorders(P<0.05).Conclusion Both external and internal-external PTBD are safe effective procedures for patients with MOJ.The use of external PTBD seems to reduce the incidence of complications.

关 键 词：恶性梗阻性黄疸 经皮肝穿刺胆道引流术 外引流 内外引流 

分 类 号：R735.8[医药卫生—肿瘤] R815[医药卫生—临床医学] R575.6