摘要
目的对3种姑息性减黄治疗对老年晚期恶性梗阻性黄疸的疗效进行比较。方法 2011年1月-2012年12月该院的95例老年晚期恶性梗阻性黄疸患者,按照治疗方法分为胆肠吻合组、经皮经肝穿刺胆管引流术(PTCD)组和经内镜逆行胰胆管造影(ERCP)胆管支架置入组,对3种姑息性治疗措施的治疗效果、术后近期并发症、住院时间及患者的生存时间进行回顾性研究。结果 ERCP胆管支架置入组较胆肠吻合组近期并发症、住院时间明显减少;PTCD组较胆肠吻合组住院时间明显缩短,近期并发症明显减少;ERCP组较PTCD组术后并发症减少。3组之间术后黄疸消退、肝功恢复情况及生存时间差异无统计学意义。结论 ERCP胆管支架置入作为一种微创性姑息性治疗手段具有创伤小、痛苦轻、效果好和适应证广等优点,对老年患者恶性梗阻性黄疸等症状的改善及生存质量的提高具有确切疗效,应优先选用。
[ Objective ] To explore the effect of 3 kinds of palliative therapeutic measures for the treatment of elder patients with advanced malignant obstructive jaundice. [Methods ] Ninety-five elder patients with advanced malignant obstructive jaundice were divided into 3 groups including the group of eholecystojejunostomy, the group of percutaneous transhepaticcholangial drainage （PTCD） and the group of endoscopic retrograde cholangiopancreatography （ERCP） in the People＇s Hospital of Henan province from January 20t 1 to December 2012. A retrospective study was carried out for the operative effect, postoperative complications, the average days of stay in hospital, the changes of jaundice and the liver function and the survival time of the patients. [Results] The patients in the group of ERCP had shorter stay in hospital and less postoperative complications compared with the patients in the group of cholangioenterostomy. The patients in the group of PTCD had shorter stay in hospital and less postoperative complications compared with the patients in the group of eholangioenterostomy. The patients in the group of ERCP had less postoperative complications compared with the patients in the group of VFCD. There were no significant differences in the change of jaundice and hepatic functions, and survival time between the three groups. [ Conclusion ] The ERCP as a minimally invasive surgery has the advantages of less pain, less trauma, good effect and wide range of indications. Therefore, the ERCP is the first choice to the treatment for the elder patients with advanced malignant obstructive jaundice.
出处
《中国内镜杂志》
北大核心
2015年第11期1148-1151,共4页
China Journal of Endoscopy
关键词
晚期恶性梗阻性黄疸
经内镜逆行胰胆管造影
胆肠吻合术
经皮经肝穿刺胆管引流术
advanced malignant obstructive jaundice
endoscopic retrograde cholangiopancreatography
cholangioenterostomy
percutaneous transhepaticcholangial drainage
