CAJ | 학술논문

目的探讨合并急性胆管炎的恶性梗阻性黄疸患者术前采用两种不同减黄方法的疗效.方法回顾性对比分析超声引导下经皮胆道穿刺置管引流(ultrasound-guided percutaneous transhepatic cholangial drainage,PTCD)22例和内镜下鼻胆管引流(endoscopic nasobiliary drainage,ENBD) 26例的术前胆道引流效果以及引流后围手术期的相关数据.结果在术前引流天数(t=3.217,P＜0.05)及引流后胆红素下降程度(t=3.178,P＜0.05)上ENBD治疗组明显优于PTCD治疗组,二者差异有统计学意义;引流后行根治性手术治疗的手术时间和术中失血,二者无差别,但术后住院时间(t=2.542,P＜0.05)和住院总时间(t=3.172,P＜0.05)上,ENBD治疗组明显短于PTCD治疗组,二者差异有统计学意义.结论恶性梗阻性黄疸合并急性胆管炎的患者,在根治性手术前若采取适当的减黄措施,ENBD手段应作为首选.
목적 탐토합병급성담관염적악성경조성황달환자술전채용량충불동감황방법적료효.방법 회고성대비분석초성인도하경피담도천자치관인류(ultrasound-guided percutaneous transhepatic cholangial drainage,PTCD)22례화내경하비담관인류(endoscopic nasobiliary drainage,ENBD) 26례적술전담도인류효과이급인류후위수술기적상관수거.결과 재술전인류천수(t=3.217,P＜0.05)급인류후담홍소하강정도(t=3.178,P＜0.05)상ENBD치료조명현우우PTCD치료조,이자차이유통계학의의;인류후행근치성수술치료적수술시간화술중실혈,이자무차별,단술후주원시간(t=2.542,P＜0.05)화주원총시간(t=3.172,P＜0.05)상,ENBD치료조명현단우PTCD치료조,이자차이유통계학의의.결론 악성경조성황달합병급성담관염적환자,재근치성수술전약채취괄당적감황조시,ENBD수단응작위수선.
Objective To evaluate effects of two different preoperative biliary drainages on patients of malignant obstructive jaundice complicated with acute cholangitis.Methods Retrospective analysis was made on effects of two preoperative biliary drainages of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD) in cases of malignant obstructive jaundice complicated with acute cholangitis.Results Days of preoperative drainage(t =3.217,P ＜ 0.05) and declines of bilirubin level after drainage (t =3.178,P ＜ 0.05) were significantly better in ENBD group (26 cases) than PTCD group (22 cases).There were no significant differences between two groups in operation time length and intraoperative blood loss after drainage.However,postoperative hospital stay (t =2.542,P ＜ 0.05) and overall stay (t =3.172,P ＜ 0.05) were significantly shorter in ENBD group compared with PTCD group.Conclusions When preoperative biliary drainage is indicated in the cases of malignant jaundice before radical surgery,ENBD should be the first choice over DTCD.