内镜下逆行胰胆管造影置入支架治疗恶性胆管梗阻的疗效分析

发布时间：2018-03-14 06:13

本文选题：经内镜逆行胰胆管造影　切入点：胆道支架　出处：《石河子大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:通过回顾性的分析历年我院恶性胆管梗阻确诊病例经内镜下放置胆管支架后的化验指标、临床症状改善情况,术后并发症发生率,支架通畅时间及生存期,探讨内镜下逆行胰胆管造影(endoscopic retrograde cholangio pancreatography,ERCP)放置不同胆道支架治疗胆道恶性梗阻的疗效,为今后寻找恶性胆管梗阻的最佳治疗方案提供依据。方法:回顾性分析2007年1月至2013年6月期间在兰州军区乌鲁木齐总医院消化科确诊胆道恶性梗阻行内镜下支架置入的患者,按不同治疗方法分为三组,即单塑料支架组,双塑料支架组和金属支架组,观察各组的成功率、引流效果、早期并发症发生情况、支架通畅时间及生存时间,并对各个观察指标进行统计学分析对比差异是否存在统计学意义。结果:1.单塑料支架、金属支架组成功率显著高于双塑料支架组(P值均0.05),金属支架组与单塑料支架组差异无统计学意义(P0.05)。2.三组术后3天的肝功能指标显著好转,分别与术前相比差异均有统计学意义(P值均0.05)。3.单塑料支架组的早期并发症发生率高于双塑料支架组、金属支架组(P值均0.05),金属支架和双塑料支架组间无显著差异(P0.05)。4.双塑料支架组的通畅时间明显长于单塑料支架组,金属支架组的支架通畅时间明显长于双塑料支架组(P值均0.05)。三组之间及两两之间平均生存时间均无统计学差异(P0.05)。结论:内镜下留置胆管支架能有效缓解胆道梗阻的临床症状;金属支架组通畅时间明显长于双塑料支架组,双塑料支架组通畅时间明显长于单塑料支架组,且金属支架组的并发症发生率低于单、双塑料支架组;对于预计生存期较长的患者尽量选择金属支架。
[Abstract]:Objective: to analyze retrospectively the laboratory indexes, clinical symptoms, postoperative complications, duration of stent patency and survival of malignant bile duct obstruction diagnosed by endoscopy in our hospital. To evaluate the effect of endoscopic retrograde cholangio pancreatography ERCP on the treatment of malignant biliary obstruction by endoscopic retrograde cholangiopancreatography (ERCP). Methods: from January 2007 to June 2013, the patients with malignant biliary obstruction diagnosed by endoscopic stenting in Department of Digestive, Urumqi General Hospital of Lanzhou military region were analyzed retrospectively. According to different treatment methods, the patients were divided into three groups: single plastic stent group, double plastic stent group and metal stent group. The success rate, drainage effect, occurrence of early complications, patency time and survival time of stent were observed in each group. The differences were statistically analyzed and compared with each other. Results: 1. Single plastic scaffold, The success rate of metal stent group was significantly higher than that of double plastic stent group (P < 0.05). There was no significant difference between metal stent group and single plastic stent group. The incidence of early complications in the single plastic stent group was higher than that in the double plastic stent group. There was no significant difference between the metal stent group and the double plastic stent group. The patency time of the double plastic stent group was significantly longer than that of the single plastic stent group, and there was no significant difference between the metal stent group and the double plastic stent group. The time of stent patency in metal stent group was significantly longer than that in double plastic stent group (P < 0.05). There was no significant difference in mean survival time between the three groups and between two groups. Conclusion: endoscopic biliary stents can effectively relieve the clinical symptoms of biliary obstruction. The patency time of metal stent group was longer than that of double plastic stent group, the patency time of double plastic stent group was longer than that of single plastic stent group, and the incidence of complications in metal stent group was lower than that in single plastic stent group. Use metal stents as far as possible for patients with longer life expectancy.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R730.5

【相似文献】