摘要
目的探讨合并急性胆管炎的恶性梗阻性黄疸患者术前采用两种不同减黄方法的疗效。方法回顾性对比分析超声引导下经皮胆道穿刺置管引流（ultrasound—guided percutaneous transhepatic cholangial drainage，PTCD）22例和内镜下鼻胆管引流（endoscopic nasobiliary drainage，ENBD）26例的术前胆道引流效果以及引流后围手术期的相关数据。结果在术前引流天数（t=3．217，P〈0．05）及引流后胆红素下降程度（t=3．178，P〈0．05）上ENBD治疗组明显优于PTCD治疗组，二者差异有统计学意义；引流后行根治性手术治疗的手术时间和术中失血，二者无差别，但术后住院时间（t=2．542，P〈0．05）和住院总时间（t=3．172，P〈0．05）上，ENBD治疗组明显短于PTCD治疗组，二者差异有统计学意义。结论恶性梗阻性黄疸合并急性胆管炎的患者，在根治性手术前若采取适当的减黄措施，ENBD手段应作为首选。
Objective To evaluate effects of two different preoperative bihary drainages on patients of malignant obstructive jaundice complicated with acute cholangitis. Methods Retrospective analysis was made on effects of two preoperative biliary drainages of ultrasound-guided percutaneous transhepatic cholangial drainage （PTCD） and endoscopic nasobiliary drainage （ENBD） in cases of malignant obstructive jaundice complicated with acute cholangitis. Results Days of preoperative drainage（ t = 3. 217 ,P 〈 0. 05 ） and declines of bilirubin level after drainage （t = 3. 178, P 〈 0.05 ） were significantly better in ENBD group （26 cases） than PTCD group （22 cases ）. There were no significant differences between two groups in operation time length and intraoperative blood loss after drainage. However, postoperative hospital stay （ t = 2. 542 ,P 〈 0. 05 ） and overall stay（ t = 3. 172 ,P 〈 0. 05 ） were significantly shorter in ENBD group compared with PTCD group. Conclusions When preoperative biliary drainage is indicated in the cases of malignant jaundice before radical surgery, ENBD should be the first choice over DTCD.
出处
《中华普通外科杂志》
CSCD
北大核心
2013年第12期945-947,共3页
Chinese Journal of General Surgery
关键词
黄疸
阻塞性
引流术
Jaundice, obstructive
Drainage
