经内镜与经皮肝穿刺胆道金属支架置入治疗肝外胆管恶性梗阻的对比分析.pdf

《经内镜与经皮肝穿刺胆道金属支架置入治疗肝外胆管恶性梗阻的对比分析.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、．堕盟童堡筮31卷第5期JCiinRes，May2014，Vol31，No5·873··论著·经内镜与经皮肝穿刺胆道金属支架置入治疗n~Il_e管恶性梗阻的对比分析-‘吴明浩(湖南省人民医院消化内科，湖南长沙410005)[摘要]【目的】探讨应用不同方式胆道金属支架置入治疗肝外胆管恶性梗阻的效果，为临床上选择更适当的方法治疗晚期恶性梗阻性黄疸提供依据。【方法】回顾性分析本院2009年1月至2013年1月经内镜胆道金属架置入术(EMBD)治疗肝外胆管恶性梗阻患者8O例(EMBD组)及经皮肝穿刺胆管造影(PTC)胆道

2、金属支架置入术治疗肝外胆管恶性梗阻患者8O例(PTC组)的临床资料。比较两组的手术成功率、术后并发症发生率、支架通畅时间及患者生存期。【结果】两组患者术后肝功能均有明显改善，两组之间比较总胆红素(TB)、碱性磷酸酶(ALP)及谷氨酰基转移酶(GGT)下降程度无显著性差异(P>0．05)，PTC组的手术成功率高于EMBD组，但并发症的发生率明显高于EMBD组(P<0．05)。两组病人术后支架通畅时间及生存期比较无显著性差异(P>0．05)。【结论】对于肝外胆道恶性梗阻患者可首选EMBD，如手术失败可考虑经PTC途径

3、行胆道支架置入。[关键词]胆汁淤积；支架；穿刺术；内窥镜检查‘ComparisonoftheEfficacyofEndoscopicVS．PercutaneousTranshepaticBiliaryMetalStentPlace-mentfortheTreatmentofMalignantExtrahepaticBiliaryObstructionWUMing—hao(DepartmentofGastroenterology，HunanProvincialPeople'sHospital，Changsha410

4、005，China)[Abstract][Objecfive]Toexploretheefficacyofdifferentwaysofmetalstentplacementforthetreatmentofadvancedmalignantobstructivejaundiceinordertoprovidethebasisforselectingbettermethodforclinicaltreat—merit．[MethodslClinicaldataof80patientswithmalignantex

5、trahepaticbiliaryobstructionundergoingendoscopicbiliarymetalstentplacementand80patientswithmalignantextrahepaticbiliaryobstructionundergoingpercutane—OUStranshepaticbiliarymetalstentplacementinourhospitalfromJan．2009toJan．2013wereanalyzedretrospec—tively．Thea

6、chievementratioofoperation，theincidenceofpostoperativecomplications，theunobstructedtimeofstentsandthesurvivaltimeofpatientsbetweentwogroupswerecompared．[Results]LiverfunctionoftWOgroupsafteroperationwassignificantlyimproved．Therewasnosignificantdifferenceinth

7、edeclineoftotalbilirubin(TB)，alkalinephosphatase(ALP)andgammaglutamyltransferase(GGT)betweentwogroups．Theachievementratioofpercutaneoustranshepaticbiliarymetalstentplacementwashigherthanthatofendoscopicbiliarymetalstentplacement，buttheincidenceofthecomplicati

8、onsofpercutaneoustranshepaticbiliarymetalstentplacementwasobviouslyhigherthanthatofendoscopicbiliarymetalstentplacement．Therewasnosignificantdifferenceintheunobstructedtimeandsurvivaltime