CAJ | 학술논문

目的：探讨肝门部恶性梗阻性黄疸单侧穿刺单通道双胆道国产支架引流的疗效、安全性。方法回顾性分析哈尔滨医科大学附属肿瘤医院2012年10月—2013年12月收治24例肝门部高位恶性梗阻性黄疸患者临床资料，每例患者均接受双国产胆道支架治疗。其中采用单通道双支架治疗9例（试验组），采用双侧通道双支架15例（对照组）；比较两组的术中穿刺肝管次数、辐射曝露剂量、操作时间、引流有效率及并发症发生率。结果试验组穿刺肝管平均1．44±0．53次，明显低于对照组3．73±0．70次，差异有统计学意义（ P＜0．01）。试验组透视下操作时间、辐射曝露剂量平均为（1152．22±335．61）s、（653．22±207．02）mGy，略低于对照组（1236．93±463．43）s、（727．00±348．52）mGy，差异无统计学意义（P＜0．05）。4周后复查肝功，试验组与对照组引流有效率分别为88．9％（8／9）、86．7％（13／15），差异无统计学意义（P＝1．00）。试验组有1例胆汁渗出，对照组有2例胆道出血，两组均无严重并发症发生。结论单通道双国产胆道支架减黄治疗损伤小、疗效确切，可选择性应用于治疗肝门区梗阻性黄疸患者。
목적：탐토간문부악성경조성황달단측천자단통도쌍담도국산지가인류적료효、안전성。방법회고성분석합이빈의과대학부속종류의원2012년10월—2013년12월수치24례간문부고위악성경조성황달환자림상자료，매례환자균접수쌍국산담도지가치료。기중채용단통도쌍지가치료9례（시험조），채용쌍측통도쌍지가15례（대조조）；비교량조적술중천자간관차수、복사폭로제량、조작시간、인류유효솔급병발증발생솔。결과시험조천자간관평균1．44±0．53차，명현저우대조조3．73±0．70차，차이유통계학의의（ P＜0．01）。시험조투시하조작시간、복사폭로제량평균위（1152．22±335．61）s、（653．22±207．02）mGy，략저우대조조（1236．93±463．43）s、（727．00±348．52）mGy，차이무통계학의의（P＜0．05）。4주후복사간공，시험조여대조조인류유효솔분별위88．9％（8／9）、86．7％（13／15），차이무통계학의의（P＝1．00）。시험조유1례담즙삼출，대조조유2례담도출혈，량조균무엄중병발증발생。결론단통도쌍국산담도지가감황치료손상소、료효학절，가선택성응용우치료간문구경조성황달환자。
Objective To discussion the efficacy and safety of single channel and double chinese -made biliary stent in high biliary malignant hilar obstructive jaundice .Methods We reviewed the clinical data of 24 malignant hilar obstructive jaundice patients treated with single channel and double chinese -made biliary stent from October 2012 to December 2013 retrospectively.Of which 9 cases(study group)were used for single channel and double stenttreatment,and 15 cases(control group)were treated by the bilateral channel;We compared the number of intraoperative percutaneous puncture hepatic duct , radiation exposure doses , operation time , drainage effectiveness and complication rates in the two groups .Results The average number of percutaneous puncture hepatic duct in the study group was 1.44 ±0.53 times,which was significantly lower than the control group (3.73 ±0.70 times).The fluoroscopy time and radiation exposure dose of study group was 1152.22 ±335.61 s and 653.22 ±207.02 mGy,which was slightly less than the control group (1236.93 ±463.43 s and 727.00 ±348.52 mGy),the difference was not statistically significant (P=0.638;P=0.572).Liver function was tested after 4 W, the drainage effectiveness of study group and the control group were 88.9%(eight-nineths),86.7%(thirteen-fifteenths),the difference was not statistically significant .One case occurred bile leakage in the study group ,2 pa-tients with hemobilia in control group ,both groups showed no serious complication .Conclusion The single chan-nel and double chinese -made biliary stent to treat high biliary malignant hilar obstructive jaundice is minimally injured and effective ,which can be selectively applied to treat patients with hepatic hilum malignant obstructive jaundice .