保健医学研究与实践2024，Vol.21Issue(9)：56-61,6.DOI:10.11986/j.issn.1673-873X.2024.09.09
不同减黄手段在肝门部胆管癌治疗中的临床效果
Clinical efficacy of different biliary decompression methods in the treatment of hepatic hilar cholangiocarcinoma
摘要
Abstract
Objective To compare the clinical efficacy of percutaneous transhepatic cholangial drainage(PTCD)and endoscopic nasobili-ary drainage(ENBD)in treating jaundice caused by different types of hilar cholangiocarcinoma(HCCA),aiming to provide a reference for clinical treatment decisions.Methods A total of 113 HCCA patients admitted to Hanzhong 3201 Hospital from January 2020 to February 2021 were selected and assigned to a control group(n=53)and an observation group(n=60)according to the treatment method.Patients in the control group received ENBD treatment,while those in the observation group received PTCD treatment.The success rate of drainage,jaundice reduction,liver function,occurrence of complications,recurrence,and survival were compared be-tween the two groups.Results The success rate of type Ⅳ drainage and the overall success rate of drainage in the observation group were significantly higher than those in the control group[83.33％(10/12)vs.22.22％(2/9);95.00％(57/60)vs.75.47％(40/53);x2=5.546,8.830,P=0.019,0.003,respectively].The jaundice reduction rate in the observation group was significantly higher than that in the control group[83.33％(50/60)vs.50.94％(27/53);x2=13.599,P＜0.001].Before jaundice reduction surgery,no sig-nificant differences were noted in serum alkaline phosphatase(ALP),alanine aminotransferase(ALT),total bile acid(TBA),and γ-glutamyl transpeptidase(γ-GT)levels between the two groups(P＞0.05);after surgery,the levels of serum ALP,ALT,TBA,andγ-GT in both groups showed reductions,and the observation group had lower levels than the control group,with significant differences(P＜0.05).The incidence of complications in the control and observation groups was 9.43％(5/53)and 5.00％(3/60),respectively,with no significant difference(x2=0.302,P=0.583).The rates of distant metastasis recurrence in the control and observation groups were 26.42％(14/53)and 15.00％(9/60),respectively,and the 3-year survival rates were 16.98％(9/53)and 26.67％(16/60),re-spectively,with no significant differences(x2=2.262,1.532,P=0.133,0.215).Conclusion Compared with ENBD,PTCD has a higher drainage success rate in treating type Ⅳ HCCA,can effectively reduce γ-GT levels,promote jaundice reduction,and contribute to liver function recovery,with a higher safety profile,making it valuable for clinical application.关键词
经皮经肝胆管引流术/经内镜鼻胆管引流术/肝门部胆管癌/黄疸/引流成功/肝功能/并发症/复发率/生存率Key words
Percutaneous transhepatic cholangial drainage/Endoscopic nasobiliary drainage/Hilar cholangiocarcinoma/Jaun-dice/Drainage success/Liver function/Complications/Recurrence rate/Survival rate分类
医药卫生引用本文复制引用
杨帆,段建峰,赵喜荣,吴林,丁建龙,赵李飞,段昌虎..不同减黄手段在肝门部胆管癌治疗中的临床效果[J].保健医学研究与实践,2024,21(9):56-61,6.基金项目
陕西省科学研发计划项目(2022SF-01413). （2022SF-01413）
