肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2012年
5期
313-315
,共3页
宋炎阳%潘振龙%姚鹏%安家泽%李海民
宋炎暘%潘振龍%姚鵬%安傢澤%李海民
송염양%반진룡%요붕%안가택%리해민
肿瘤%黄疸,阻塞性%姑息治疗%随访研究
腫瘤%黃疸,阻塞性%姑息治療%隨訪研究
종류%황달,조새성%고식치료%수방연구
Neoplasms%Jaundice,obstructive%Palliative care%Follow-up studies
目的 探讨对恶性梗阻性黄疸姑息手术术式的选择.方法 对112例姑息性手术治疗的恶性梗阻性黄疸患者临床资料进行回顾性分析.结果 手术死亡率7.1％(8/112)；术后复发性胆管炎发生率17.3％(13/75)；术后生存期:胆肠Roux-en-Y吻合术组[(9.4±1.6)个月]与开腹支架内引流术组[(9.8±12.5)个月]、经皮经肝胆和引流(PTCD)内支架引流术组[(9.0±3.1)个月]差异无统计学意义(均P＞ 0.05),与开腹桥式内引流术组[(6 8±1.7)个月]差异有统计学意义(P＜0.05),与逆行胰胆管造影(ERCP)内支架引流术组[(3.5±2.2)个月]和单纯开腹探查术组[(2.8±2.7)个月]比较差异有统计学意义(P＜0.01).结论 胆肠Roux-en-Y吻合术式适用于胆管中、下段梗阻,开腹内支架引流术式适用于肝门胆管梗阻患者,ERCP内支架术式仅适用于胆管下段的梗阻,PTCD内支架术式适用于任何一段的梗阻.胆管空肠Roux-en-Y吻合术、开腹支架内引流术和PTCD内支架引流术能够延长患者术后生存期和提高生活质量.
目的 探討對噁性梗阻性黃疸姑息手術術式的選擇.方法 對112例姑息性手術治療的噁性梗阻性黃疸患者臨床資料進行迴顧性分析.結果 手術死亡率7.1％(8/112)；術後複髮性膽管炎髮生率17.3％(13/75)；術後生存期:膽腸Roux-en-Y吻閤術組[(9.4±1.6)箇月]與開腹支架內引流術組[(9.8±12.5)箇月]、經皮經肝膽和引流(PTCD)內支架引流術組[(9.0±3.1)箇月]差異無統計學意義(均P＞ 0.05),與開腹橋式內引流術組[(6 8±1.7)箇月]差異有統計學意義(P＜0.05),與逆行胰膽管造影(ERCP)內支架引流術組[(3.5±2.2)箇月]和單純開腹探查術組[(2.8±2.7)箇月]比較差異有統計學意義(P＜0.01).結論 膽腸Roux-en-Y吻閤術式適用于膽管中、下段梗阻,開腹內支架引流術式適用于肝門膽管梗阻患者,ERCP內支架術式僅適用于膽管下段的梗阻,PTCD內支架術式適用于任何一段的梗阻.膽管空腸Roux-en-Y吻閤術、開腹支架內引流術和PTCD內支架引流術能夠延長患者術後生存期和提高生活質量.
목적 탐토대악성경조성황달고식수술술식적선택.방법 대112례고식성수술치료적악성경조성황달환자림상자료진행회고성분석.결과 수술사망솔7.1％(8/112)；술후복발성담관염발생솔17.3％(13/75)；술후생존기:담장Roux-en-Y문합술조[(9.4±1.6)개월]여개복지가내인류술조[(9.8±12.5)개월]、경피경간담화인류(PTCD)내지가인류술조[(9.0±3.1)개월]차이무통계학의의(균P＞ 0.05),여개복교식내인류술조[(6 8±1.7)개월]차이유통계학의의(P＜0.05),여역행이담관조영(ERCP)내지가인류술조[(3.5±2.2)개월]화단순개복탐사술조[(2.8±2.7)개월]비교차이유통계학의의(P＜0.01).결론 담장Roux-en-Y문합술식괄용우담관중、하단경조,개복내지가인류술식괄용우간문담관경조환자,ERCP내지가술식부괄용우담관하단적경조,PTCD내지가술식괄용우임하일단적경조.담관공장Roux-en-Y문합술、개복지가내인류술화PTCD내지가인류술능구연장환자술후생존기화제고생활질량.
Objective To explore the selection of palliate operation styles for unresectable malignant obstructive jaundice diseases. Methods The clinical data of 112 cases of unresectable malignant obstructive jaundice diseases in the last 5 years were analyzed retrospectively. Results The rate of operation mortality was 7.1％ and the incidence rate of post-operative cholangitis was 17.3 ％.The survival time in the Roux-en-Y choledochojejunostomy group was (9.4±1.6) months, and there were no significant differences among laparotomy stent internal drainage group[(9.8±12.5)months]and the PTCD stent internal drainage group [(9.0± 3.1)months]. But survival time in the laparotomy bridge internal drainage group [(6.8±1.7)months]was significantly lower (P＜0.05). The survival times in the ERCP stent drainage group [(3.5±2.2)months]and exploratory laparotomy group [(2.8±2.7)months]were even more significantly lower (P＜0.01).Conclusion As a palliative operation for unresectable malignant obstructive jaundice diseases, Roux-en-Y choledochojejunostomy applies to the middle and distal obstruction,laparotomy stent internal drainage applies to hilar obstruction,ERCP stent drainage only applies to distal obstruction,and PTCD stent internal drainage applies to any part obstruction of the bile duct. The Roux-en-Y choledochojejunostomy, laparotomy stent internal drainage, and PTCD stent internal drainage would improve the life time and life quality of these patients.
