经倾向性匹配后EUS-BD和PTBD在恶性胆道梗阻治疗中的应用效果比较  

Comparison of the therapeutic effects of EUS-BD and PTBD in the treatment of malignant biliary obstruction after propensity score matching

作　　者：李宇新 刘逸 丁炎波[1] 陈炳芳[1] 孙克文[1] LI Yuxin;LIU Yi;DING Yanbo;CHEN Bingfang;SUN Kewen(Department of Gastroenterology,the First People's Hospital of Changzhou,Changzhou,Jiangsu 213003,China)

机构地区：[1]常州市第一人民医院消化内科,江苏常州213003

出　　处：《医药前沿》2024年第28期16-19,共4页Journal of Frontiers of Medicine

摘　　要：目的:通过倾向性匹配法均衡两组病例的基线资料后,比较超声内镜引导下胆道穿刺引流(EUS-BD)和经皮肝胆管引流(PTBD)在恶性胆道梗阻治疗中的应用效果。方法:回顾性分析2015年1月—2023年12月常州市第一人民医院201例接受EUS-BD或PTBD治疗的住院恶性胆道梗阻患者的临床资料,根据治疗方法的不同分为EUS-BD组29例,PTBD组172例,将两组病例的年龄、性别、梗阻来源、是否消化道改道、胆道梗阻分型等因素进行1∶2倾向性匹配后,EUS-BD组纳入22例患者、PTBD组纳入41例患者。比较两组患者的梗阻性黄疸改善、再发梗阻及并发症发生情况。结果:倾向性匹配后,两组的总胆红素下降值、直接胆红素下降值比较,差异均无统计学意义(P>0.05)。两组再发梗阻率比较,差异无统计学意义(P>0.05),但PTBD组脱管率较高。结论:EUS-BD与PTBD在恶性胆道梗阻中的治疗效果无明显差异,可作为恶性胆道梗阻患者的一线选择。Objective To compare the therapeutic effects of endoscopic ultrasound-guided biliary drainage(EUS-BD)and percutaneous transhepatic biliary drainage(PTBD)in the treatment of malignant biliary obstruction(MBO)after balancing the baseline data of two groups of cases through propensity score matching.Methods A retrospective analysis was conducted on the clinical data of 201 patients with MBO admitted to the First People's Hospital of Changzhou from January 2015 to December 2023,who received either EUS-BD or PTBD.According to the treatment method,29 patients were assigned to the EUS-BD group and 172 patients to the PTBD group.Propensity score matching was performed at a 1∶2 ratio based on factors such as age,gender,source of obstruction,gastrointestinal diversion,and classification of biliary obstruction,resulting in the inclusion of 22 patients in the EUS-BD group and 41 patients in the PTBD group.The improvement of obstructive jaundice,recurrent obstruction and the occurrence of complications were compared between the two groups.Results After propensity score matching,no statistically significant differences were observed between the two groups in the reduction of total bilirubin and direct bilirubin levels(P>0.05).The comparison of recurrent obstruction rate also showed no significant differences(P>0.05).however,the rate of tube dislodgement was higher in the PTBD group.Conclusions There is no significant difference in the therapeutic effect between EUS-BD and PTBD in malignant biliary obstruction,and they can be used as first-line choices for patients with malignant biliary obstruction.

关 键 词：倾向性匹配 内镜超声引导下胆道穿刺引流 经皮肝胆管引流 恶性胆道梗阻 

分 类 号：R657[医药卫生—外科学]