经皮肝胆管穿刺置管引流术治疗胆道梗阻的临床效果

摘要

Objective To investigate the clinical effect ofpercutaneous transhepatic cholangial drainage for biliary obstruction.Methods 60 patients with biliary obstruction admitted into our hospital from January,2012 to January,2016 were randomly divided a control group and an experimental group.The control group were surgically treated and the experimental group were treated by percutaneous transhepatic cholangial drainage.The therapeutic effect,clinical indicators before and after treatment,postoperative complications were compared between these two groups.Results The total effective rate was significantly higher in the experimental group than in the control group (100.00％ vs.83.33％),with a statistical difference (P ＜ 0.05).After the treatment,the levels of TBIL,DBIL,AST,ALT,GGT,and ALP were (170.25 ± 39.72),(74.99 ± 29.04),(62.12 ± 20.35),(58.11 ± 25.14),(221.88 ± 80.72),and (253.36 ± 81.21) in the experimental group and were (243.08 ± 46.55),(90.73 ± 31.27),(84.28 ± 22.27),(99.25 ± 35.09),(316.45 ± 86.66),and (320.02 ± 83.94) in the control group.the overall incidence of postoperative complications was significantly in the experimental lower than the control group (23.33％ vs.60.00％),with a statistical difference (P ＜ 0.01).Conclusions Percutaneous transhepatic cholangial drainage for biliary obstruction is effective and safe,so it is worth for reference.%目的 探讨经皮肝胆管穿刺置管引流术(Percutaneous Transhepatic Cholangial Drainage,PTCD)治疗胆道梗阻的临床效果.方法 收集2012年1月至2016年1月入院的60例胆道梗阻患者,随机分为两组;对照组患者采用外科手术治疗,实验组则采用经皮肝胆管穿刺置管引流术;比较两组患者近期治疗效果、治疗前后相关临床指标与术后并发症.结果 实验组患者治疗总有效率(100.00％)明显高于对照组(83.33％),差异有统计学意义(P＜0.05);实验组患者术后TBIL为(170.25±39.72)μmol/L、DBIL为(74.99±29.04)μmol/L、AST为(62.12±20.35) U/L、ALT为(58.11±25.14) U/L、GGT为(221.88±80.72) U/L、ALP为(253.36±81.21)U/L,均显著低于对照组[分别为(243.08±46.55)μmol/L,(90.73±31.27)μ mol/L,(84.28±22.27)U/L,(99.25±35.09) U/L,(316.45±86.66)U/L,(320.02±83.94)U/L];总体术后并发症发生率(23.33％)显著低于对照组(60.00％),差异有显著统计学意义(P＜0.01).结论 经皮肝胆管穿刺置管引流术治疗胆道梗阻的临床效果显著,且安全性较高,具有借鉴性.