摘要
目的探讨经内镜放置胆管支架治疗恶性胆管梗阻的效果。方法176例失去手术机会的恶性胆管梗阻患者于经内镜逆行胰胆管造影下放置胆管支架,其中70例行胆管单塑料支架引流术(单支架组),52例行胆管双塑料支架引流术(双支架组),54例行胆管金属支架引流术(金属支架组),对比研究各组的引流效果及早期并发症的发生情况。结果术后1周时,单支架组、双支架组和金属支架组的谷丙转氨酶、总胆红素、直接胆红素和碱性磷酸酶水平均较治疗前显著下降(P值均<0.05);双支架组和金属支架组的总胆红素和直接胆红素水平均显著低于单支架组(P值均<0.05),而双支架组与金属支架组间的差异无统计学意义(P值均>0.05)。单支架组、双支架组和金属支架组的手术成功率分别为97.1%(68/70)、78.8%(41/52)和92.6%(50/54),单支架组的手术成功率显著高于双支架组(P<0.05),金属支架组与单支架组、双支架组的差异均无统计学意义(P值均>0.05)。单支架组、双支架组和金属支架组早期并发症发生率分别为15.7%(11/70)、13.5%(7/52)和1.9%(1/54),单支架组、双支架组的早期并发症发生率显著高于金属支架组(P值均<0.05),单支架组与双支架组的差异无统计学意义(P>0.05)。结论经内镜逆行胰胆管造影下放置胆管支架对于恶性胆管梗阻有肯定的引流效果,双支架和金属支架的引流效果优于单支架。
Objective To evaluate the efficacy of endoscopic placement of biliary stent in treatment of malignant biliary obstruction.Methods A total of 176 patients with maligmant biliary obstruction,who had lost the chance for surgery,were treated with biliary stent through endoscopic retrograde cholangiopancreatography.Seventy patients received endoscopic retrograde biliary drainage with single stent,52 patients with double stents,and 54 patients with endoscopic metal biliary endoprothesis.The drainage outcomes and the early complications were compared between different groups.Results The levels of alkaline phosphatase（ALT）,total bilirubin（TB）,direct bilirubin（DB） and alkaline phosphatase（AKP） in the three groups were significantly decreased after operation compared with before operation（P〈0.05）.The post-stenting levels of TB and DB of in double stent and metal stent groups were significantly lower than those of the single stent group（P〈0.05）,but with no significant difference found between the former two groups（P〉0.05）.The successful rate of single stent group（97.1%） was significantly higher than that of the double stent group（78.8%,P〈0.05）,but they were not significantly different from that of the metal stent group（92.6%）（P〉0.05）.The incidences of early complications of the single stent（15.7%） and double stent（13.5%） groups were significantly higher than that of metal stent（1.9%） group,but with no significant difference found between the former two（P〉0.05）.Conclusion Endoscopic stenting is effective in treatment of malignant biliary obstruction,and the efficacies of endoscopic retrograde biliary drainage with double stent and metal biliary endoprothesis are better than that with single stent.
出处
《上海医学》
CAS
CSCD
北大核心
2010年第1期100-103,共4页
Shanghai Medical Journal
关键词
经内镜逆行胰胆管造影
胆管支架
恶性胆管梗阻
Endoscopic retrograde cholangiopancreatography
Biliary stent
Malignant biliary obstruction
