摘要
目的比较经皮肝穿刺胆道引流术(PTCD)与姑息性胆肠内引流术对恶性梗阻性黄疸(MOJ)的疗效。方法选取我院收治的80例MOJ患者,按照手术方式差异分为A组与B组,A组行经皮肝穿刺胆道引流术,B组行姑息性胆肠内引流术,比较2组手术前后肝功能[天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰基转移酶(γ-GGT)]、胆道梗阻指标[直接胆红素(DBIL)与总胆红素(TBIL)]、术中出血量、住院时间及并发症情况。结果2组术后AST、ALT、γ-GGT、DBIL、TBIL水平均较术前明显降低(P<0.05);A组术后DBIL、TBIL水平显著低于B组(P<0.05);A组术中出血量明显少于B组(P<0.05),且住院时间明显短于B组(P<0.05);2组住院期间并发症总发生率比较无明显差异(P>0.05)。结论PTCD与姑息性胆肠内引流均能有效改善MOJ患者胆道梗阻与肝功能,PTCD解除胆道梗阻效果更好,且创伤更小,更安全。
Objective To compare the curative effect between percutaneous transhepatic cholangial drainage ( PTCD) and palliative biliary drainage on malignant obstructive jaundice (MOJ).Methods 80 MOJ patients who were admitted to the hospital were enrolled.They were divided into group A and group B according to differences in surgical methods.Group A underwent PTCD, while group B underwent palliative biliary drainage.Liver function [aspartate aminotransferase ( AST),alanine aminotransferase (ALT),glutamyltransferase (γ-GGT)],biliary obstruction indexes [direct bilirubin (DBIL) and total bilirubin (TBIL)],intraoperative blood loss,hospital stays and complications before and after surgery were compared between the two groups.Results After surgery, levels of AST,ALT,γ-GGT,DBIL and TBIL ibth group were significantly decreased (P < 0.05).After surgery,levels of DBIL and TBIL in group A were significantly lower than those in group B (P < 0.05).The intraoperative blood loss in group A was significantly less than that in group B (P < 0.05),and hospital stays was significantly shorter than that in group B (P < 0.05).There was no significant difference in total incidence of complications between two groups during hospitalization period (P > 0.05).Conclusion Both PTCD and palliative biliary drainage can effectively improve biliary obstruction and liver function in MOJ patients.The effect of PTCD is better on relieving biliary obstruction,with less trauma and higher safety.Comparative analysis on curative effect between percutaneous transhepatic cholangial drainage and palliative biliary drainage on patients with malignant obstructive jaundice.
作者
余快
李秋
YU Kuai;LI Qiu(Department of Hepatobiliary Surgery,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《肝胆外科杂志》
2019年第3期187-190,共4页
Journal of Hepatobiliary Surgery
关键词
恶性梗阻性黄疸
经皮肝穿刺胆道引流术
姑息性胆肠内引流术
malignant obstructive jaundice
percutaneous transhepatic cholangial drainage
palliative biliary drainage
