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经皮经肝胆道引流术(PTBD)与经皮经肝胆道球囊扩张术(PTBS)治疗恶性梗阻性黄疸的疗效比较

[Comparison of the therapeutic effects of PTBD and PTBS in treatment of malignant obstructive jaundice].

作者信息

Bai Ai-Guo, Zheng Chuan-Sheng, Zhou Guo-Feng, Liang Hui-Min, Feng Gan-Sheng

机构信息

Department of Interventional Radiology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2010 Jun;32(6):456-8.

Abstract

OBJECTIVE

To summarize and compare the short-term and long-term clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and percutaneous transhepatic biliary stent (PTBS) in the treatment of malignant obstructive jaundice.

METHODS

210 cases of malignant obstructive jaundice underwent interventional therapy, of which 161 cases of drainage catheters placement and 49 cases of metallic stent implantation. Follow-up information was obtained through telephone review or check-up records.

RESULTS

The technical success rate of technique was 100%. At 3 - 5 days after treatment, the serum total bilirubin in 15 metallic stent-treated patients was decreased by (178.04 +/- 42.32) micromol/L, and direct bilirubin by (83.97 +/- 23.63) micromol/L. Compared with those of 28 cases treated with drainage catheters: (95.67 +/- 34.28) micromol/L and (49.84 +/- 28.21) micromol/L, there were statistically significant differences between the two groups (P = 0.017 and P = 0.035). At 6 - 9 days after treatment, the serum total bilirubin in 28 cases of metallic stent group was decreased by (188.22 +/- 79.90) micromol/L, and that in 126 cases of drainage catheter group decreased by (141.39 +/- 65.32) micromol/L. The difference was statistically significant (P = 0.014). But the decline value of direct bilirubin had no significant difference. The median patency period and the median survival time of the drainage catheter group were 60 and 148 days, respectively, those of metallic stent group were 197 days and 245 days. There were statistically significant differences between the two groups (P < 0.05).

CONCLUSION

The results of this study indicate that the short-term and long-term efficacies of metallic stent implantation are better than those of catheter drainage technique.

摘要

目的

总结并比较经皮经肝胆道引流术(PTBD)与经皮经肝胆道支架置入术(PTBS)治疗恶性梗阻性黄疸的短期和长期临床疗效。

方法

210例恶性梗阻性黄疸患者接受介入治疗,其中161例行引流管置入,49例行金属支架植入。通过电话随访或检查记录获取随访信息。

结果

技术成功率为100%。治疗后3 - 5天,15例金属支架治疗患者血清总胆红素下降(178.04±42.32)μmol/L,直接胆红素下降(83.97±23.63)μmol/L。与28例引流管治疗患者相比:(95.67±34.28)μmol/L和(49.84±28.21)μmol/L,两组差异有统计学意义(P = 0.017和P = 0.035)。治疗后6 - 9天,28例金属支架组血清总胆红素下降(188.22±79.90)μmol/L,126例引流管组下降(141.39±65.32)μmol/L。差异有统计学意义(P = 0.014)。但直接胆红素下降值无显著差异。引流管组的中位通畅期和中位生存时间分别为60天和148天,金属支架组分别为197天和245天。两组差异有统计学意义(P < 0.05)。

结论

本研究结果表明,金属支架植入术的短期和长期疗效均优于导管引流术。

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