两种胆道引流术治疗肝门部胆管癌所致黄疸的效果观察.docVIP

两种胆道引流术治疗肝门部胆管癌所致黄疸的效果观察 　　[摘要] 目的 探讨两种胆道引流术治疗肝门部胆管癌所致黄疸的效果。 方法 选取2010年12月～2012年12月来本院就诊的肝门部胆管癌89例患者，按胆道引流方法的不同分为经内镜鼻胆管引流术（ENBD）组45例及经皮经肝穿刺胆管引流术（PTCD）组44例，对两组患者的引流成功率、肝功能相关指标、胆汁引流量及并发症发生率进行比较。 结果 ENBD组的引流成功率为73.33%，明显低于PTCD组的90.91%，两组比较差异有统计学意义（P0.05）。ENBD组并发症发生率为17.78%，PTCD组并发症发生率为29.54%，两组比较差异有统计学意义（P0.05）。 结论 两种胆管引流术均可有效缓解肝门部胆管癌引起的黄疸，改善肝功能；PTCD为Ⅳ型肝门部胆管癌首选治疗方法，但PTCD后胆道出血发生率较高。 　　[关键词] 两种胆道引流术；肝门部胆管癌；黄疸 　　[中图分类号] R735.8[文献标识码] A[文章编号] 1674-4721（2014）06（b）-0049-03 　　 　　Effect observation of two kinds of biliary drainage in the treatment of jaundice caused by hilar cholangiocarcinoma 　　LIAO Jun-ping HUANG Yan-jin LIANG Ri-guang LIANG Yong-ren OU Guang-wu LIU Jie-wen 　　Department of Hepatobiliary Surgery,People′s Hospital of Gaozhou City in Guangdong Province,Gaozhou525200,China 　　[Abstract] Objective To explore the curative effect of two kinds of biliary drainage in the treatment of jaundice caused by hilar cholangiocarcinoma. Methods 89 cases of patients with hilar cholangiocarcinoma from December 2010 to December 2012 in our hospital were selected.According the different biliary drainage method,all patients were divided into endoscopic nasobiliary drainage(ENBD)group(45 cases)and percutaneous transhepatic cholangio drainage(PTCD)group(44 cases).Drainage success rate,related indicator of liver function,bile drainage and the incidence rate of complication in two groups was compared respectively. Results The drainage success rate of ENBD group was 73.33%,significantly lower than that of PTCD group(90.91%),with a statistical difference(P0.05).The incidence rate in ENBD group was 17.78%,incidence rate of PTCD group was 29.54%,with statistical difference(P0.05). Conclusion Two kinds of biliary drainage can effectively alleviate the hepatic portal cholangiocarcinoma caused by jaundice,and improve liver function.PTCD is the preferred method in the treatment of type Ⅳ hilar cholangiocarcinom,but PTCD has a higher incidence of biliary tract bleeding. 　　[Key word