经内镜逆行胰胆管造影术与经皮肝穿刺胆道引流术治疗恶性梗阻性黄疸的比较

发布时间：2018-04-11 10:21

本文选题：经内镜逆行胰胆管造影术 + 经皮肝穿刺胆道引流术　；参考：《中华全科医学》2016年04期

【摘要】：目的探讨经内镜逆行胰胆管造影术(ERCP)与经皮肝穿刺胆道引流术(PTCD)治疗恶性梗阻性黄疸的临床效果,为临床选择术式提供参考。方法选择140例恶性梗阻性黄疸患者,按照治疗术式分为ERCP组与PTCD组。对比2组患者手术成功率、黄疸缓解率、并发症、治疗成本及相关临床指标。结果 ERCP组与PTCD组低位梗阻及高位梗阻手术成功率分别为94.74%vs.71.43%、84.21%vs.100.00%,对比差异均有统计学意义(P0.05);ERCP组与PTCD组低位梗阻及高位梗阻黄疸缓解率分别为98.25%vs.78.57%、68.42%vs.92.00%,对比差异均有统计学意义(P0.05);两组ALT、DBIL、TBIL术后2周与术前均有明显改善,对比差异有统计学意义(P0.05);ERCP组与PTCD组,整体并发症发生率为5.26%vs.17.19%,对比差异有统计学意义(P0.05),ERCP组与PTCD组低位梗阻黄疸并发症发生率分别为1.75%vs.28.57%,对比差异有统计学意义(P0.05);ERCP组与PTCD组住院时间、手术费用、治疗费用分别为(13.54±2.54)d vs.(20.14±3.38)d、(2.62±0.15)万元vs.(2.15±0.41)万元、(4.82±0.69)万元vs.(5.04±0.71)万元,住院时间、手术费用对比差异有统计学意义(P0.05)。结论 ERCP与PTCD治疗恶性梗阻性黄疸均可以取得较好的临床效果,低位梗阻首选ERCP治疗,高位梗阻首选PTCD治疗。
[Abstract]:Objective to explore the endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTCD) clinical effect of the treatment of malignant obstructive jaundice, to provide the reference for the clinical choice of surgery. Methods 140 cases of patients with malignant obstructive jaundice, in accordance with the treatment of surgery were divided into ERCP group and PTCD group compared to 2. Group of patients with the success rate of surgery, jaundice remission rate, complications, treatment costs and related clinical indicators. The results of ERCP group and PTCD group, low obstruction and high obstruction operation success rate were 94.74%vs.71.43%, 84.21%vs.100.00%, contrast the differences were statistically significant (P0.05); ERCP group and PTCD group, low obstruction and obstructive jaundice remission rate was high 98.25%vs.78.57%, 68.42%vs.92.00%, contrast the differences were statistically significant (P0.05); group DBIL, two ALT, 2 week before and after surgery were significantly improved after TBIL, there was statistically significant difference (P0.05); ERCP group and PTCD group Overall, the complication rate was 5.26%vs.17.19%, there was statistically significant difference (P0.05), ERCP group and PTCD group low obstructive jaundice complication rate was 1.75%vs.28.57%, there was statistically significant difference (P0.05); ERCP group and PTCD group, the hospitalization time, operation fee, cost of treatment respectively (13.54 + 2.54) d vs. (20.14 + 3.38) d, (2.62 + 0.15) vs. million yuan (2.15 + 0.41) million, million yuan (4.82 + 0.69) vs. (5.04 + 0.71) million yuan, the hospitalization time, the difference was statistically significant compared with surgery costs (P0.05). Conclusion ERCP and PTCD for the treatment of malignant obstructive jaundice can have a good clinical effect, the preferred treatment of low ERCP obstruction, preferred PTCD treatment of high obstruction.

【作者单位】：武警浙江省总队杭州医院放射科;
【分类号】：R657.43

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