摘要
目的探讨三种常用的姑息性减黄措施对恶性梗阻性黄疸(MOJ)的治疗效果。方法 230例晚期不能行肿瘤根治术的MOJ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)并胆管引流术组,对三种姑息性治疗措施的手术效果、术后并发癌、平均住院日及病人的生存时间进行回顾性研究。结果 ERCP组较胆肠吻合组住院时间明显缩短,医疗费用明显减少,近期并发症明显减少;PTCD组较胆肠吻合组住院时间明显缩短,医疗费用明显减少,近期并发症明显减少;ERCP组较PTCD组术后并发症减少。三组之间术后黄疸消退、肝功恢复情况及生存时间无显著性差异。结论 ERCP下的胆管引流术具有适应证广、微创、安全、经济实用等优点,应优先选用,PTCD次之。
Objective To explore the effect of 3 kinds of palliative therapeutic measures for the treatment of patients with malignant obstructive jaundice.Methods Two hundred and thirty patients with advanced malignant obstructive jaundice who are unresectable were divided into 3 groups including the group of cholecystojejunostomy,the group of percutaneous transhepatic cholangial drainage(PTCD) and the group of endoscopic retrograde cholangiopancreatography(ERCP) in Qilu Hospital from December2006 to December 2010.A retrospective study was carried out for the operative effect,the incidence of postoperative complications,the average days of stay in hospital,the changes of jaundice and the liver function,operative mortality rate,long-term life quality and survival time of the patients.Results The patients in the group of ERCP had shorter days of stay in hospital,less medical expense and less postoperative complications compared with the patients in the group of cholangioenterostomy.The patients in the group of PTCD had shorter days of stay in hospital,less medical expenses and less postoperative complications compared with the patients in the group of cholangioenterostomy.The patients in the group of ERCP had less postoperative complications compared with the patients in the group of PTCD.There were no significant differences in the change of jaundice and hepatic functions,life quality and survival time between the group of cholangioenterostomy,the group of PTCD and the group of ERCP.Conclusion The ERCP has the advantages of wide range of indications,minimal invasiveness and less medical expense.Therefore,the ERCP is first choice to the treatment for the patients with advanced malignant obstructive jaundice and the PTCD is the second.
出处
《临床普外科电子杂志》
2013年第1期47-51,共5页
Journal of General Surgery for Clinicians(Electronic Version)
