徐青松

摘要：目的 分析PTCD（经皮肝胆管穿刺引流）在肝门部胆管癌中的应用效果。方法 选取我院收治的肝门部胆管癌晚期患者40例，按照不同治疗方法将其分成胆道支架置入组与PTCD组各20例，胆道支架置入组应用经开腹胆道支架置入胆管内引流术治疗，PTCD组应用经皮肝胆管穿刺引流术治疗，对比两种治疗方法的临床应用效果。结果 对比两组患者的肝功能，PTCD组的ALT、AST、AST/ALT指标均优于胆道支架置入组，差异显著（P<0.05）；PTCD组的引流成功率（92.50%）明显高于胆道支架置入组（70.00%），对比差异显著（P<0.05）；PTCD组的并发症发生率（17.50%）略高于胆道支架置入组（15.00%），对比差异不显著（P>0.05）。结论 PTCD在肝门部胆管癌中的应用效果显著，可明显改善患者的肝功能，减轻患者术后痛苦，减少并发症，引流成功率较高，值得推广。

关键词：经皮肝胆管穿刺引流术；胆道支架置入胆管内引流术；肝门部；胆管癌

中图分类号：R735.8 文献标识码：A 文章编号：1006-1959（2017）14-0076-02

Application of Transhepatic Cholangiopancreatic Drainage in Hilar Cholangiocarcinoma

XU Qing-song

（Department of Hepatobiliary Surgery，Chuxiong People's Hospital of Yunnan Province，Chuxiong 675000，Yunnan，China）

Abstract：Objective To analyze the effect of PTCD（percutaneous transhepatic bile duct drainage）in hilar cholangiocarcinoma.Methods 40 patients with advanced cholangiocarcinoma were randomly divided into two groups，the bile duct stent group and the PTCD group.Biliary stent placement group was treated with open bile duct stent implantation into the bile duct drainage，PTCD group was treated with percutaneous transhepatic bile duct puncture and drainage，and the clinical application effect of the two treatment methods was compared.Results Liver function were compared between the two groups，PTCD group，ALT，AST，AST/ALT indicators are better than the biliary stenting group，significant difference（P<0.05）；drainage success rate of PTCD group（92.50%）was significantly higher than that of biliary stent group（70.00%），significant differences（P<0.05）；the incidence of complications in PTCD group（17.50%）is slightly higher than that of biliary stent group（15.00%），compared with no significant difference（P>0.05）.Conclusion The application effect of PTCD in hilar cholangiocarcinoma is significant，can significantly improve the patient's liver function，reduce postoperative pain， reduce complications，drainage and high success rate，worthy of promotion.

Key words：Percutaneous transhepatic bile duct drainage；Biliary stent implantation in the bile duct drainage；Hilar；Cholangiocarcinoma

肝门部胆管癌（hilar cholangiocarcinoma，HC）是一种恶性肿瘤，会对患者的身心健康与生活质量造成严重的影响[1]。本研究为了进一步分析分析PTCD在肝门部胆管癌中的应用效果，选取我院2014年2月～2017年2月收治的40例患者的临床资料进行回顾性分析，报道如下。

1 资料与方法

1.1一般资料

选取我院收治的40例肝门部胆管癌患者作为研究对象，所有患者均经实验室检查、影像学检查等确诊，符合临床诊断标准，临床上均表现出不同程度的阻塞性黄疸、皮肤巩膜黄染、尿黄、皮肤瘙痒等症状，部分患者伴有上腹隐痛不适、发热等表现[2]。按照不同治疗方法将其分成胆道支架置入组与PTCD组各20例。ENBD组：男24例，女16例；年龄26～81岁，平均（52.6±3.9）岁；Bismuth-Corlette分型中，Ⅰ型4例，Ⅱ型9例，Ⅲ型19例，Ⅳ型8例；形态分类中，息肉型4例，结节型8例，硬化型28例。……