梗阻性黄疸在内镜引导下安置胆胰管双支架治疗的安全性探讨
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摘要
目的探讨梗阻性黄疸患者在内镜引导下安置胆胰管双支架治疗的安全性。方法选择本院2012年1月-2015年1月收治的100例梗阻性黄疸患者进行研究,按照随机数目表法分为实验组和对照组各50例。实验组接受内镜引导下的胆胰管双支架治疗,对照组仅行传统的胆管内支架治疗,对比两组患者的治疗效果和术后不良反应发生情况。结果所有患者手术均一次性操作成功,两组患者TBIL、DBIL、ALT、AST指标较术前均明显降低,P<0.05;组间比较术后实验组各指标下降幅度明显大于对照组,P<0.05;实验组和对照组不良反应发生率相当(4.0%vs 8.0%),差异无统计学意义(P>0.05)。结论对梗阻性黄疸患者行内镜引导下的胆胰管双支架治疗,疗效显著,并发症发生率少,安全性高,值得临床推广运用。
Objective To investigate the safety of endoscopic double stent drainage in cholangiopancreatic duct for patients with obstructive jaundice. Methods 100 patients with obstructive jaundice hospitalized from January 2012 to January 2015 were averagely assigned into two groups according to the random digit number table. The patients in the experimental group received endoscopic double stent drainage in cholangiopancreatic duct while those in the control group were treated with traditional biliary tract prosthesis therapy. Efficacy and postoperative adverse reaction in the two groups were analyzed and compared. Results All patients underwent one successful operation. The TBIL,DBIL,ALT and AST in both groups were decreased significantly( P < 0. 05). The decrease of the indicators in the experimental group was significantly greater than that in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reaction between the experimental group and the control group( 4. 0% vs 8. 0%,P > 0. 05). Conclusion The endoscopic double stent drainage in cholangiopancreatic duct for patients with obstructive jaundice has a higher efficacy,lower incidence of complications and higher safety,thus worth promoting in the clinical application.
Objective To investigate the safety of endoscopic double stent drainage in cholangiopancreatic duct for patients with obstructive jaundice. Methods 100 patients with obstructive jaundice hospitalized from January 2012 to January 2015 were averagely assigned into two groups according to the random digit number table. The patients in the experimental group received endoscopic double stent drainage in cholangiopancreatic duct while those in the control group were treated with traditional biliary tract prosthesis therapy. Efficacy and postoperative adverse reaction in the two groups were analyzed and compared. Results All patients underwent one successful operation. The TBIL,DBIL,ALT and AST in both groups were decreased significantly( P < 0. 05). The decrease of the indicators in the experimental group was significantly greater than that in the control group( P < 0. 05). There was no significant difference in the incidence of adverse reaction between the experimental group and the control group( 4. 0% vs 8. 0%,P > 0. 05). Conclusion The endoscopic double stent drainage in cholangiopancreatic duct for patients with obstructive jaundice has a higher efficacy,lower incidence of complications and higher safety,thus worth promoting in the clinical application.
引文
[1]郑金辉,何利平,陈勇,等.内镜下胰胆管逆行造影术在胆胰管导管内乳头状黏液性瘤中的应用价值[J].中国内镜杂志,2015,21(6):567-570.
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[10]卢秋良,林芳,段浩清,等.内镜逆行胰胆管造影术治疗急性胆源性胰腺炎的临床观察[J].现代医院,2014,14(11):90-92.
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[13]丁斌,孙辉,刘志国,等.经内镜序贯植入双金属支架治疗胆道并十二指肠恶性梗阻9例疗效观察[J].中国内镜杂志,2012,18(2):203-205.
[14]姚寒晖,黄强,邵峰.内镜下逆行胰胆管造影置放胆道支架治疗胆道恶性梗阻52例疗效观察[J].肝胆外科杂志,2014,22(2):116-117.
[2]范震,张筱凤,张啸,等.胆胰管双支架治疗胰头癌患者的临床疗效观察[J].中华消化内镜杂志,2013,30(4):181-184.
[3]朱晓亮,周文策,李汛,等.早期经内镜胆胰管支架并营养管置入治疗急性胆源性胰腺炎的临床观察[J].兰州大学学报(医学版),2014,40(4):47-51.
[4]谭学明,范志宁.胆胰管支架临床应用应注意的问题[J].肝胆外科杂志,2014,22(6):408-409.
[5]王昱良,郑永青,杜睿,等.经内镜逆行性胰胆管造影与经皮肝穿刺胆道引流金属支架置入治疗恶性阻塞性黄疸的疗效比较[J].中国基层医药,2015,17(21):3217-3219,3220.
[6]彭卫军,陈爱民,蒋寒,等.超声定位结合DSA引导下经皮肝穿刺胆道引流术在恶性梗阻性黄疸中的应用[J].临床医学工程,2015,22(10):1273-1275.
[7]倪志,何周桃,张荣春,等.经内镜置入胆道及十二指肠自膨式金属支架治疗恶性梗阻性黄疸并十二指肠梗阻[J].华南国防医学杂志,2016,30(9):589-591.
[8]曹丽.超声引导经皮肝穿刺胆管置管引流术治疗恶性梗阻性黄疸的临床效果[J].国际医药卫生导报,2016,22(3):385-387.
[9]潘亚敏,王田田,高道键,等.内镜下同期胆、肠双金属支架置入治疗胆管及十二指肠恶性梗阻[J].第二军医大学学报,2013,34(3):261-265.
[10]卢秋良,林芳,段浩清,等.内镜逆行胰胆管造影术治疗急性胆源性胰腺炎的临床观察[J].现代医院,2014,14(11):90-92.
[11]董理,王琦,冷君志,等.胆胰管双支架治疗晚期胰头癌37例临床分析[J].宁夏医科大学学报,2014,36(2):199-201.
[12]姜中华,杨红梅,王正江,等.内镜置入胆道、十二指肠支架对胆道合并十二指肠恶性梗阻的治疗价值[J].中国内镜杂志,2015,21(5):479-482.
[13]丁斌,孙辉,刘志国,等.经内镜序贯植入双金属支架治疗胆道并十二指肠恶性梗阻9例疗效观察[J].中国内镜杂志,2012,18(2):203-205.
[14]姚寒晖,黄强,邵峰.内镜下逆行胰胆管造影置放胆道支架治疗胆道恶性梗阻52例疗效观察[J].肝胆外科杂志,2014,22(2):116-117.