高位恶性胆道梗阻介入手术入路与并发症的对比分析

doi:10.3969/j.issn.10073205.2017.04.015

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗分析右侧入路单通道及双侧入路双通道胆道双支架植入内引流在高位恶性胆道梗阻（malignant high biliary obstruction,MHBO）中的应用价值。
〖HTH〗方法〖HTSS〗〖KG*2〗MHBO患者141例，其中数字减影血管造影（digital subtraction angiography,DSA）下经右侧右胆管穿刺建立右侧单工作通道后，行胆道双支架植入内引流，即右侧入路单通道胆道双支架植入（简称右侧单通道胆道双支架植入）组（A组）103例，DSA下分别穿刺左、右胆管建立双工作通道后，行胆道双支架植入内引流，即双侧入路双通道胆道双支架植入（简称双侧双通道胆道双支架植入）组（B组）38例；分析及比较不同介入手术入路的近期并发症与疗效。
〖HTH〗结果〖HTSS〗〖KG*2〗2组患者术前总胆红素值比较，差异无统计学意义（P＞005）；2组患者术后第21天总胆红素水平均较术前明显下降，但术后2组比较差异无统计学意义（P＞005)。A组患者胆道出血、胆汁漏、胆心反射、穿刺点疼痛、引流管脱落发生率明显少于B组，差异有统计学意义（P＜005）；2组患者胆道感染、引流管渗液发生率差异无统计学意义（P＞005）；2组患者均未发生胸膜损伤、肝脓肿、胰腺炎。
〖HTH〗结论〖HTSS〗〖KG*2〗右侧单通胆道双支架植入技术简化了操作步骤，减少了操作创伤及并发症，是治疗MHBO安全有效的方法，具有明显的临床实际应用价值。

关键词: 胆汁淤积, 支架, 手术中并发症

Abstract: ［Abstract］ Objective〖HTSS〗〓To analyze the application value of right single channel and bilateral double channel of biliary double stents implant combine with biliary extradrainage in treating malignant high biliary obstruction(MHBO).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and fortyone patients of MHBO, including 103 patients with digital subtraction angiography guiding, punctured on the right side of right billiary, established right single channel, implanted biliary double stents with biliary internal drainage, namely the right side of single channel of biliary double stents implant(right side single biliary double stent implantation, group A), and 38 cases are punctured on the right and left billiary, establish bilateral double channel, implanted biliary double stents with biliary internal drainage, namely bilateral double channel of biliary double stents implant(double channel double biliary stent implantation, group B). The different complications and short term curative effects of 2 groups were analyzed and compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Twentyfirst days after operation, the total bilirubin levels of the patients in the 2 groups were significantly lower than those before the operation. However, there was no significant difference between the 2 groups after operation(P＞005).The incidence rate of hemobilia, bile leakage,biliary cardiac reflex, puncture point pain, drainage tube slip in group A is lower than that in group B, and the difference is significant(P＜005). There was no significant difference between the 2 groups in the incidence of biliary infection and drainage tube(P＞005). Two groups of patients had no pleural injury, liver abscess, pancreatitis. There was no significant difference on the total bilirubin between the 2 groups before and after the operation at twentyfirst days(P＞005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The technique of single side biliary double stents is a safe and effective method for the treatment of MHBO, and has obvious clinical application value.

Key words: cholestasis, stents, intraoperative complications

武中林,李智岗,杨〓光,吴勇超,荣小翠,李顺宗*. 高位恶性胆道梗阻介入手术入路与并发症的对比分析[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2017.04.015.

WU Zhonglin, LI Zhigang, YANG Guang, WU Yongchao, RONG Xiaocui, LI Shunzong*. Comparative analysis of interventional procedures and complications of high malignant biliary obstruction#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2017.04.015.

[1]	房军臣, 李莉, 陈新, 蒲伟丛, 马莉, 邱向利. 高危早产儿肠外营养相关性胆汁淤积的危险因素及转归分析 [J]. 河北医科大学学报, 2023, 44(4): 444-449.
[2]	肖峰. 异种脱细胞膀胱黏膜下层支架的制备[J]. 河北医科大学学报, 2023, 44(10): 1129-1132,1140.
[3]	王亚玲, 饶明月, 郭安君, 张杨, 孟建康. 药物球囊治疗冠状动脉小血管病变的效果和不良反应观察[J]. 河北医科大学学报, 2022, 43(5): 517-520.
[4]	姚东陂, 缪中荣. CT灌注成像评价参数半定量分析与颈动脉支架术后脑高灌注综合征的相关性研究[J]. 河北医科大学学报, 2021, 42(4): 477-479.
[5]	刘德敏, 马雅楠, 谷国强. 最新药物涂层球囊专家共识解读[J]. 河北医科大学学报, 2021, 42(11): 1241-1244,1260.
[6]	赵甲彧1，刘雅婷2，朱男1，张芳2. TIMI心肌灌注帧数在STEMI患者PCI术后MVO评价中的应用[J]. 河北医科大学学报, 2020, 41(9): 1011-1015,1064.
[7]	赵珍，李睿聪，景尚华*. 覆膜支架联合手术治疗头颈部癌侵犯颈动脉在绵羊模型中的试验性研究[J]. 河北医科大学学报, 2020, 41(6): 637-640,645.
[8]	杜超1，张丽华2，江平1*，王立君1，秦利强1，张国瑞1. 高血栓负荷伴弥漫性病变的STEMI患者延期支架植入术的效果观察[J]. 河北医科大学学报, 2020, 41(4): 377-381,435.
[9]	张铁军，贾鹏宇，许鹏. 置入输尿管支架管早期干预小婴儿重度肾积水的疗效评估[J]. 河北医科大学学报, 2020, 41(3): 295-297,314.
[10]	张〓军，林瑞敏，刘〓军，陈〓占，张在兴，欧云崧. 药物涂层球囊治疗下肢动脉硬化闭塞症的临床观察#br#[J]. 河北医科大学学报, 2019, 40(2): 178-180,197.
[11]	刘微，赵丽艳*，陈微. 上肢骨折患者术中应用改良屏风与拱形支架防辐射装置的对比研究[J]. 河北医科大学学报, 2019, 40(11): 1339-1342.
[12]	李旭斌，贾军峰*，张其军，单海丰，张〓杰. 分析置入肠道支架联合新辅助化疗对梗阻型左半结肠癌患者手术效果及肿瘤恶性生物学行为的影响[J]. 河北医科大学学报, 2019, 40(1): 60-64,69.
[13]	陈〓源，马雪玲，马素苓，耿江辉，张少丹. 婴儿胆汁淤积性肝病的肝功能评估及价值[J]. 河北医科大学学报, 2017, 37(3): 293-296.
[14]	陈〓源，马雪玲，耿江辉，张少丹. 婴儿胆汁淤积性肝病高危因素分析[J]. 河北医科大学学报, 2017, 38(2): 177-179,183.
[15]	肖连波1，韩建京2，檀俊涛3，杨〓光4，李〓勇2*. 丙泊酚麻醉下Y形气管支架置入术病例分析[J]. 河北医科大学学报, 2017, 38(2): 246-248.

高位恶性胆道梗阻介入手术入路与并发症的对比分析

Comparative analysis of interventional procedures and complications of high malignant biliary obstruction#br#

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价