【摘要】 目的探析经皮肝胆道支架置入与内镜下塑料支架置入治疗对恶性梗阻性黄疸患者肝功能指标、减黄程度及术后并发症的影响。方法将我院自2013年12月~2017年6月间收治的恶性梗阻性黄疸患者纳入研究范围,将其就诊编号按随机分层法分为A组(n=44)与B组(n=40),A组经皮肝胆道支架置入治疗,B组内镜下塑料支架置入治疗,对比一般治疗情况、肝功能指标、减黄程度及术后并发症发生率。结果 A组支架成功率为90.91%,略高于B组的82.50%,胆汁引流量、住院费用均略低于B组,且A组并发症总发生率为22.73%,略低于B组的27.50%,但上述对比差异无统计学意义(P>0.05);同时,治疗后两组ALP、γ-GGT、ALT、TBIL、DBIL、TBA等指标水平均显著下降,但A组低于B组,且对比差异有统计学意义(P<0.05)。结论较内镜下塑料支架置入治疗,经皮肝胆道支架置入治疗恶性梗阻性黄疸对患者肝功能指标、黄染程度的改善更显著,或具更高的支架置入成功率、更低的并发症发生率。更多还原

【Abstract】 Objective To investigate the effects of percutaneous transhepatic biliary stent implantation and endoscopic plastic stent implantation on the liver function,degree of biliary drainage and postoperative complications in patients with malignant obstructive jaundice. Methods Patients with malignant obstructive jaundice who were admitted to the hospital from December 2013 to June 2017 were enrolled in the study. They were randomly divided into group A( n = 44) and group B( n = 40). Group A was treated by percutaneous transhepatic biliary stent implantation while group B was treated with endoscopic plastic stent implantation. The general situation of treatment,liver function indexes,degree of biliary drainage and the incidence rate of postoperative complications were compared.Results The success rate of stent implantation in group A was slightly higher than that in group B( 90. 91% vs 82. 50%). The bile drainage volume and hospitalization expenses of group A were slightly less than those of group B. The total incidence rate of complications in group A was slightly lower than that in group B( 22. 73% vs 27. 50%)( all P > 0. 05). After treatment,levels of ALP,γ-GGT,ALT,TBIL,DBIL and TBA were significantly decreased in the two groups,and the levels were lower in group A than in group B( P < 0. 05). Conclusion Compared with endoscopic plastic stent implantation,percutaneous transhepatic biliary stent implantation can improve the liver function and relieve jaundice in patients with malignant obstructive jaundice more significantly,with higher success rate and lower incidence rate of complications.更多还原