胆肠架桥内引流与胆肠Roux-en-Y吻合术在恶性梗阻性黄疸治疗中相关指标对比

发布时间：2018-03-21 21:43

本文选题：恶性梗阻性黄疸　切入点：胆肠Roux-en-Y吻合术　出处：《宁夏医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的回顾性研究分析胆肠Roux-en-Y吻合术与胆肠(十二指肠)架桥内引流术治疗恶性梗阻性黄疸相关指标有无统计学差异,为恶性梗阻性黄疸患者行姑息治疗时术式选择提供有价值的参考。方法选取我院近10年(2003年至2013年)因恶性梗阻性黄疸行胆肠Roux-en-Y吻合术与胆肠(十二指肠)架桥内引流术治疗的恶性梗阻性黄疸患者共69例。运用统计学原理进行回顾性分析,比较两种术式术前术后血清胆红素变化、手术时间、术中出血量、住院天数、并发症发生率有无统计学差异。结果胆肠Roux-en-Y吻合组患者和架桥内引流组患者术后第7天血清胆红素均明显下降且有统计学差异(P0.05)。而且从第10天开始,架桥内引流组血清胆红素下降较胆肠吻合组更明显且有统计学差异(P0.05)。胆肠Roux-en-Y吻合组和架桥内引流组在手术时间、住院天数、术后生存时间无统计学差异(P0.05),两组术式术中出血量有统计学差异(P0.05)。并发症发生率无统计学差异(P0.05)。结论架桥内引流术相比胆肠Roux-en-Y吻合术而言,其手术操作简单,临床恢复较快;,临床近期效果肯定,远期治疗效果满意,有其更为良好的治疗效果,为胆胰肠内引流术提供了又一种较为理想的术式。
[Abstract]:Objective to study retrospectively whether there are statistical differences between Roux-en-Y anastomosis of gallbladder and duodenal bridging drainage in the treatment of malignant obstructive jaundice. To provide a valuable reference for palliative treatment in patients with malignant obstructive jaundice methods during the last 10 years (2003-2013) due to malignant obstructive jaundice, choledochojejunostomy and biliary (duodenal) bridging were performed in our hospital. 69 cases of malignant obstructive jaundice were treated by internal drainage. The changes of serum bilirubin before and after operation, the time of operation, the amount of intraoperative bleeding, the days of hospitalization were compared. Results the serum bilirubin levels in Roux-en-Y anastomosis group and bridging internal drainage group were significantly decreased on the 7th day after operation, and there were significant differences in the incidence of complications (P 0.05), and from the 10th day after operation, there were significant differences in serum bilirubin levels between the two groups. The decrease of serum bilirubin in bridging drainage group was more obvious than that in choledochojejunostomy group (P 0.05). There was no significant difference in survival time between the two groups (P 0.05). There was no significant difference in the amount of intraoperative bleeding between the two groups (P 0.05). There was no significant difference in the incidence of complications (P 0.05). Conclusion compared with Roux-en-Y anastomosis, the procedure is simple. The clinical recovery is faster, the clinical short-term effect is positive, the long-term treatment effect is satisfactory, and has its better therapeutic effect, which provides another kind of more ideal operation for biliary and pancreatic enteric drainage.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

【参考文献】