摘要
目的分析经皮经肝胆管穿刺置管引流术联合介入手术治疗老年恶性梗阻性黄疸(MOJ)的临床效果。方法62例老年MOJ患者为研究对象,按随机数字表法分为对照组和研究组,每组31例。对照组实施经皮经肝胆管穿刺置管引流术治疗,研究组实施经皮经肝胆管穿刺置管引流术联合介入手术治疗。比较两组治疗效果、肝功能指标、并发症发生率及治疗前后炎症因子水平。结果研究组治疗总有效率90.32%高于对照组的67.74%,差异有统计学意义(P<0.05)。治疗前,两组肿瘤坏死因子-α(TNF-α)、核因子-κB(NF-κB)、C反应蛋白(CRP)水平比较,差异无统计学意义(P>0.05)。治疗后,研究组TNF-α(18.06±2.53)ng/L、NF-κB(12.16±2.06)pg/ml、CRP(6.46±1.68)mg/L均明显低于对照组的(25.53±3.32)ng/L、(22.99±2.83)pg/ml、(9.63±1.5)mg/L,差异有统计学意义(P<0.05)。研究组血清总胆红素(55.46±17.74)μmol/L、血清直接胆红素(29.92±8.16)μmol/L均明显低于对照组的(76.36±11.83)、(43.83±11.98)μmol/L,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论临床对老年MOJ患者实施经皮经肝胆管穿刺置管引流术联合介入手术治疗,不仅能改善患者肝功能,减轻炎症因子水平,还能降低其并发症发生率,安全性较高,临床上值得推广使用。
Objective To analyze the clinical effect of percutaneous transhepatic biliary drainage combined with interventional surgery in the treatment of malignant obstructive jaundice(MOJ)in the elderly.Methods A total of 62 elderly patients with MOJ were divided into control group and study group according to random numerical table,with 31 cases in each group.The control group was treated with percutaneous transhepatic biliary drainage,and the study group was treated with percutaneous transhepatic biliary drainage and interventional surgery.The therapeutic effect,liver function index,incidence of complications,and inflammatory factor level before and after treatment were compared between the two groups.Results The total effective rate of 90.32%in the study group was higher than that of 67.74%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the levels of tumor necrosis factor-α(TNF-α),nuclear factor-κB(NF-κB)and C-reactive protein(CRP)between the two groups(P>0.05).After treatment,the study group had TNF-αof(18.06±2.53)ng/L,NF-κB of(12.16±2.06)pg/ml and CRP of(6.46±1.68)mg/L,which were significantly lower than those of(25.53±3.32)ng/L,(22.99±2.83)pg/ml and(9.63±1.5)mg/L in the control group,and the differences were statistically significant(P<0.05).Serum total bilirubin of(55.46±17.74)μmol/L and serum direct bilirubin of(29.92±8.16)μmol/L in the study group were significantly lower than those of(76.36±11.83)and(43.83±11.98)μmol/L in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Clinical implementation of percutaneous transhepatic biliary drainage combined with interventional surgery in elderly patients with MOJ can not only improve the liver function of patients,reduce the level of inflammatory factors,but also reduce the incidence of complications,which is safe and worthy of clinical promotion.
作者
姜继强
JIANG Ji-qiang(Department of Gastroenterology,Juye County Beicheng Hospital,Heze 274900,China)
出处
《中国实用医药》
2023年第19期45-48,共4页
China Practical Medicine
关键词
恶性梗阻性黄疸
经皮经肝胆管穿刺置管引流术
介入手术
老年
并发症
炎症因子
Malignant obstructive jaundice
Percutaneous transhepatic biliary drainage
Interventional surgery
Old age
Complications
Inflammatory factors
