内镜下胆管支架在胆管狭窄治疗中的应用  

Application of endoscopic bile duct stents in the treatment of biliary stenosis

作　　者：刘洁[1] 贾璐璐 高倩[1] Liu Jie;Jia Lulu;Gao Qian(Digestive Endoscopy Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院消化内镜中心,郑州450000

出　　处：《中国实用医刊》2024年第5期8-11,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨内镜下胆管支架应用于胆管狭窄治疗中的效果。方法回顾性抽取2021年3月至2023年3月郑州大学第一附属医院收治的胆管狭窄患者82例,依据置入支架的材质分为A组(41例,塑料支架)和B组(41例,金属支架)。比较两组胆管狭窄缓解情况、复发情况、肝功能改善情况、手术并发症、支架使用情况和治疗费用。结果B组胆管狭窄缓解率(100.00%,41/41)与A组(97.56%,40/41)比较,差异未见统计学意义(P>0.05);B组狭窄复发率(2.44%,1/41)低于A组(19.51%,8/41),P<0.05。术后4周,两组总胆红素、丙氨酸转氨酶、天冬氨酸转氨酶低于术前1 d(P<0.05),但两组前述指标比较差异未见统计学意义(P>0.05)。B组手术并发症发生率(4.88%,2/41)低于A组(19.51%,8/41),P<0.05。B组治疗费用多于A组,B组支架堵塞率(2.44%,1/41)低于A组(17.07%,7/41),B组支架移位率(2.44%,1/41)低于A组(19.51%,8/41),P<0.05。结论内镜下置入胆管塑料支架、金属支架均能有效缓解胆管狭窄,改善肝功能,金属支架复发率、并发症发生率、支架堵塞率、支架移位发生率更低,但费用相对昂贵。Objective To investigate the application effect of endoscopic bile duct stents in the treatment of biliary stenosis.Methods A total of 82 patients with biliary stenosis admitted to the First Affiliated Hospital of Zhengzhou University from March 2021 to March 2023 were retrospectively selected,and they were divided into group A(41 cases,treated by plastic stents)and group B(41 cases,treated by metal stents)according to the material of the stent.The remission and recurrence of bile duct stenosis,improvement of liver function,surgical complications,stent use and treatment cost of the two groups were compared.Results The remission rate of bile duct stenosis in the group B was 100.00%(41/41),which had no significant difference with the group A(97.56%,40/41),P>0.05.The recurrence rate of bile duct stenosis in the group B(2.44%,1/41)was lower than that in the group A(19.51%,8/41),P<0.05.Four weeks after operation,the total bilirubin,alanine transaminase and aspartate transaminase in the two groups were lower than those at 1 day before operation(P<0.05),but there was no statistical difference in the above indices between the two groups(P>0.05).The incidence of surgical complication of the group B was 4.88%(2/41),lower than the 19.51%(8/41)in the group A(P<0.05).The treatment cost of the group B was higher than that of the group A(P<0.05).The stent blockage rate of the group B(2.44%,1/41)was lower than that of the group A(17.07%,7/41),while the stent displacement rate of the group B(2.44%,1/41)was lower than that of the group A(19.51%,8/41),P<0.05.Conclusions Both plastic and metal stents in endoscopic biliary stenting for biliary stenosis can achieve good effects in alleviating biliary stenosis and improving liver function.The recurrence rate,complication rate,stent blockage rate and stent displacement rate of metal stents are lower,but the cost is relatively more expensive.

关 键 词：胆管狭窄 塑料支架 金属支架 并发症 

分 类 号：R575.7[医药卫生—消化系统]