经内镜逆行途径胆道支架置入术治疗68例恶性梗阻性黄疸患者的效果分析

目的 探讨通过内镜逆行胰胆管造影术(ERCP)联合胆道支架置入治疗恶性梗阻性黄疸患者的临床应用价值。 方法 本文回顾性分析2011年1月1日-2014年12月31日期间在温州医科大学附属第二医院接受经ERCP途径胆道支架置入的68例失去手术切除机会或拒绝手术的恶性梗阻性黄疸患者,在全麻下行经ERCP途径胆道支架置入,借此重新打开堵塞的胆道,进而达到胆汁的正常引流。 结果 本研究68例患者中男性46例,女性22例,年龄28~99岁,平均(67.57±12.78)岁,治疗前血清总胆红素值(TBil)为(217.72±125.54)μmol/L,治疗后1周下降至(149.24±126.92)μmol/L,治疗前血清直接胆红素值(DBil)为(126.46±70.69)μmol/L,治疗后1周下降至(75.55±68.66)μmol/L,差异具有统计学意义(P<0.05);治疗前后肝功能其他指标也得到明显降低。其中14例患者减黄效果较差,支架置入后1周黄疸缓解率为79.41%。患者的术后平均生存期为(10.13±10.49)个月。 结论 经ERCP途径胆道支架置入不仅可以延长患者生存期和改善生活质量,而且具有安全、简便、创伤小、可重复等优点,是一种姑息性治疗恶性梗阻性黄疸的有效方法之一。 

Analysis of endoscopic stenting for malignant biliary obstruction:a study of 68 patients

Objective To describe the clinical application value of implant biliary metal/plastic stents by endoscopic retrograde cholangiopancreatography (ERCP) to cure malignant obstructive jaundice. Methods We analyzed 68 cases of malignant biliary obstruction by endoscopic stenting between January 1,2011 to December 31,2014 in the Second Affiliated Hospital of Wenzhou Medical University. Results In this study,68 patients,46 male and 22 females,aged 28 to 99 years,mean age (67.57±12.78) years.Before the treatment,serum total bilirubin (TBil) was (217.72±125.54)μmol/L,and decreased to (149.24±126.92)μmol/L after one week treatment;serum direct bilirubin (DBil) was (126.46±70.69)μmol/L,and decreased to (75.55±68.66)μmol/L on after e week treatment,the difference was statistically significant (P<0.05);after the treatment,other liver function indicators also decreased significantly.14 caught a poor effect in diminishing jaundice,with a rate of 79.41% at one week after stent implanting.The mean survival time of patients was (10.13±10.49) months. Conclusion Endoscopic stenting for malignant biliary obstruction can improve the quality of life of patients,prolong survival,and have many advantages,such as safe,simple,minimally invasive,repeatable and so on.It is an effective way to treat malignant obstructive jaundice.