内镜超声引导下胆道引流治疗远端胃切除后解剖结构异常胆道梗阻的效果观察  

Effect of endoscopic ultrasound-guided biliary drainage in the treatment of biliary obstruction with abnormal anatomical abnormalities after distal gastrectomy

作　　者：罗钢[1] 熊少敏[1] 赵新华[1] LUO Gang;XIONG Shaomin;ZHAO Xinhua(The Second Department of Hepatobiliary Extrapancreatic Surgery,Jiujiang NO.1 People's Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院肝胆胰外二科,江西九江332000

出　　处：《当代医学》2023年第6期87-89,共3页Contemporary Medicine

基　　金：江西省卫生健康委科技计划项目(202140301)。

摘　　要：目的探讨内镜超声引导下胆道引流治疗远端胃切除后解剖结构异常胆道梗阻的效果。方法选取2019年3月至2020年10月九江市第一人民医院收治的60例远端胃切除后解剖结构异常胆道梗阻患者作为研究对象,根据随机数字表法分为对照组与研究组,每组30例。对照组接受传统经内镜逆行胰胆管造影置管引流手术治疗,研究组接受内镜超声引导下胆道引流手术治疗,比较两组肝功能指标、手术情况及并发症发生情况。结果研究组手术时间、引流时间与住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。治疗后,研究组谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)水平均低于治疗前和对照组,差异有统计学意义(P<0.05);治疗后,对照组ALT、TBIL、DBIL水平均低于治疗前,差异有统计学意义(P<0.05),但对照组治疗前后AST水平比较差异无统计学意义。研究组并发症发生率低于对照组,但组间比较差异无统计学意义。结论内镜超声引导下胆道引流治疗远端胃切除后解剖结构异常胆道梗阻的效果确切,可有效减轻手术治疗创伤,有效保护患者肝功能,且可在一定程度上减少并发症的发生。Objective To investigate the effect of endoscopic ultrasound-guided biliary drainage in the treatment of biliary obstruction with abnormal anatomical abnormalities after distal gastrectomy.Methods 60 patients with biliary obstruction with abnormal anatomical structure after distal gastrectomy in the Jiujiang NO.1 People's Hospital from March 2019 to October 2020 were selected as the research subjects,and they were divided into the control group and the study group according to random number table method,with 30 cases in each group.The control group received the traditional endoscopic retrograde cholangiopancreatography tube drainage surgery,the study group received endoscopic ultrasound-guided biliary drainage surgery,the indexes of liver function,operation and the occurrence of complications were compared between the two groups.Results The operation time,drainage time and hospitalization time in the study group were shorter than those in the control group,and the blood loss during operation was less than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and direct bilirubin(DBIL)in the study group were lower than those in before treatment and the control group,the differences were statistically significant(P<0.05);after treatment,the levels of ALT,TBIL and DBIL in the control group were lower than those before treatment,and the differences were statistically significant(P<0.05),but there was no statistically significant difference in the level of AST in the control group before and after treatment.The incidence of complications in the study group was lower than that in the control group,but the difference was not statistically significant between the two groups.Conclusion Endoscopic ultrasound-guided biliary drainage is effective in the treatment of biliary obstruction with abnormal anatomical structure after distal gastrectomy,which can effectively reduce surgical traum

关 键 词：内镜超声引导 胆道引流 远端胃切除 解剖结构异常 胆道梗阻 

分 类 号：R657.4[医药卫生—外科学]