【作者】 蒋雨卉；

【导师】 张俊文；

【作者基本信息】 重庆医科大学 ， 消化内科学， 2010， 硕士

【摘要】 目的探讨分析经内镜胆管支架置入术治疗恶性胆管梗阻的疗效并将其与外科姑息手术行对比。方法回顾对比31例行胆管支架置入术及29例行外科姑息手术治疗的恶性胆管梗阻患者资料。结果(1)经内镜胆管支架置入术成功率为93.55%。(2)行支架置入术与行外科姑息手术后,患者的肝功各项指标均有改善,改善程度方面两组尚无明显差别(P>0.05)。(3)支架术后患者近期并发症出现率9.68%,与外科组的17.24%相比尚无明显差别(P>0.05)。(4)支架组术后住院时间中位数为5天,短于外科组的13天(P<0.05)。(5)支架组术后胆道平均通畅时间为154.95天,外科组为223.37天,两组尚无明显差别(P>0.05)。(6)支架术平均生存时间182.06天与外科组为239.37天相比尚无明显差别(P>0.05)。结论(1)胆管支架置入术安全可行,对缓解恶性梗阻性黄疸效果良好。(2)胆管支架置入术对中晚期恶性梗阻性黄疸之疗效不逊于外科手术,基本可替代姑息性手术治疗。更多还原

【Abstract】 Objectives To investigate the efficacy of biliary stent placement through endoscope to treat malignant biliary obstruction and compare it with surgical palliation.Methods Analysed the data of 31 cases of malignant biliary obstruction patients treated by biliary stent placement and the data of 29 cases of this kind disease patients treated by surgical palliation retrospectivelyResults (1)The percent of the successful biliary stent placement is 93.55%.(2)The function of liver can be protected through both biliary stent placement and surgical palliation, and their degree for it is not different obviously(p>0.05). (3)The rate of recent complications is 9.68% in the group of biliary stent placement while it is 17.24% in the surgical palliation group. It is not different obviously(p>0.05)between the two groups.(4)The median time in hospital of the patients treated by biliary stent placement is 5 days. It is shorter than this time of the patients who have surgical palliation which is 13 days(p<0.05). (5)The average unobstructed time of biliary after stent placement is 154.95 days and this time is 223.37 days in surgical palliation group. They are not different obviously(p>0.05).(6) In stent group,the average live time of patients is 182.06 days and it is 239.37 days in surgical palliation group. The two time is not different obviously(p>0.05).Conclusions (1)Bliary stent placement is safe and efficient. It has efficacy to malignant biliary obstruction.(2) The efficacy of stent placement is not worse than surgical palliation. So to the malignant biliary obstruction patients in advanced stage,the billiary stent placement can almostly replace the surgical palliation.更多还原