PTCD和ERCP在梗阻性黄疸治疗中的应用

熊翔

[摘要]目的 探讨PTCD和ERCP在梗阻性黄疸治疗中的应用。方法 选取2014年1月～2016年12月我院收治的36例梗阻性黄疸患者作为研究对象，根据患者身体情况及自愿为原则，分为PTCD组和ERCP各18例。PTCD组采用经皮肝穿刺胆道引流术（PTCD）治疗，ERCP组采用内镜逆行胰胆管造影术（ERCP）治疗，对比两组患者的临床效果。结果 治疗良性梗阻性黄疸时，ERCP组术后5 d血清总胆红素下降水平、并发症发生率优于PTCD组，差异有统计学意义（P<0.05）；两组手术成功率差异无统计学意义（P>0.05）。在治疗恶性梗阻性黄疸时，PTCD手术成功率、术后5 d血清总胆红素水平优于ERCP组，差异有统计学意义（P<0.05）；两组并发症发生率无明显差异（P>0.05）。结论 ERCP与PTCD均有其优势，临床可根据患者的实际情况合理选择，提高治疗的临床效果。

[关键词]PTCD；ERCP；梗阻性黄疸；应用

[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-4721（2017）05（b）-0043-03

Application of PTCD and ERCP in the treatment of obstructive jaundice

XIONG Xiang

Department of Surgery，Maoming Hospital of Traditional Chinese Medicine in Guangdong Province，Maoming 525000，China

[Abstract]Objective To research the application of PTCD and ERCP in the treatment of obstructive jaundice.Methods 36 cases with obstructive jaundice in our hospital from January 2014 to December 2016 were selected as research objects and then they were divided into two groups according to physical conditions of patients and the principle of voluntariness，18 cases in each group.Treated with Percutaneous Transhepatic Choledochus Drainage （PTCD） in the PTCD group and treated with Endoscopic Retrograde Cholangiopancreatography （ERCP） in the ERCP group.The clinical effects of patients were compared in pairs.Results In the treatment of benign obstructive jaundice， thedeclining level of 5 d serum total bilirubin and the complication occurring rate after operation in ERCP group were better than that in the PTCD group， the difference between the two groups was statistically significant （P<0.05）.The operative success rates of two groups had no significant differences （P>0.05）.In the treatment of malignant obstructive jaundice， the operative success rate and declining level of 5 d serum total bilirubin after operation in PTCD group were better than ERCP group， the difference between the two groups was statistically significant （P<0.05）.The complication occurring rates of two groups had no significant differences （P>0.05）.Conclusion ERCP and PTCD have their own advantages.In the clinical treatment， the reasonable choice should be made based on the actual conditions of patients to improve the clinical effects of treatment.

[Key words]PTCD；ERCP；Obstructive jaundice；Application

梗阻性黃疸又称为阻塞性黄疸、胆汁淤积性黄疸，由于肝外胆管系统梗阻导致胆汁排泄不正常，或肝内胆汁淤积出现黄疸，是临床中的常见病症之一[1]。如果没有及时治疗，可引发患者全身病理生理改变[2]，例如肝细胞变性坏死、肝肾衰竭、凝血功能障碍等，对患者的生命造成了严重的影响。根据梗阻性黄疸的特性，可以分为良性和恶性两类[3]。临床中大多通过传统外科手术、经内镜下引流术以及经皮肝穿刺导管引流术进行治疗[4-5]。本研究采用经皮肝穿刺胆道引流术（PTCD）以及内镜逆行胰胆管造影术（ERCP）治疗梗阻性黄疸，取得了良好的临床效果，现报道如下。

1资料与方法

1.1 一般资料

选取2014年1月～2016年12月我院收治的36例梗阻性黄疸作为研究对象，根据患者身体情况及自愿为原则，分为PTCD组和ERCP各18例。……