CAJ | 학술논문

目的：比较内镜下逆行胰胆管造影（ ERCP）胆管支架置入与传统手术方法解除恶性胆道梗阻的临床疗效及安全性。方法根据患者手术方法不同将92例恶性胆道梗阻患者分入A组、B组及C组，3组患者分别接受传统外科手术治疗、ERCP置入塑料支架治疗及ERCP置入金属支架治疗。结果3组生存时间无显著差别（P＞0．05）。 C组术后胆道通畅时间显著长于B组，差别具有统计学意义（P＜0．05）。 B组及C组住院时间显著少于A组（P＜0．05）。术后1周B组及C组肝功能检测指标显著优于A组（P＜0．05）。 A组、B组及C组并发症发生率分别为43．8％、14．3％和15．6％（P＜0．05）。结论 ERCP支架置入与传统手术方法解除胆道恶性梗阻疗效相当，但前者术后并发症少，患者肝功能指标恢复快，行金属支架置入者引流效果更为理想。
목적：비교내경하역행이담관조영（ ERCP）담관지가치입여전통수술방법해제악성담도경조적림상료효급안전성。방법근거환자수술방법불동장92례악성담도경조환자분입A조、B조급C조，3조환자분별접수전통외과수술치료、ERCP치입소료지가치료급ERCP치입금속지가치료。결과3조생존시간무현저차별（P＞0．05）。 C조술후담도통창시간현저장우B조，차별구유통계학의의（P＜0．05）。 B조급C조주원시간현저소우A조（P＜0．05）。술후1주B조급C조간공능검측지표현저우우A조（P＜0．05）。 A조、B조급C조병발증발생솔분별위43．8％、14．3％화15．6％（P＜0．05）。결론 ERCP지가치입여전통수술방법해제담도악성경조료효상당，단전자술후병발증소，환자간공능지표회복쾌，행금속지가치입자인류효과경위이상。
Objective To compare the clinical efficacy and safety of biliary stent insertion by endoscopic retrograde cholangiopancreatography( ERCP) and traditional operation for patients with malignant biliary obstruction.Methods 92 cases of malignant biliary obstruction were divided into group A,group B and group C according to the surgery method.Group A,group B and group C respectively received traditional operation,biliateral plastic stent drainage via ERCP and biliateral metal stent drain-age via ERCP.Results There were no significant difference in survival time among the 3 groups (P>0.05);Postoperative pa-tency period in group C was significantly longer than that of group B,there had significant difference ( P<0.05); The hospital stay in group B and group C were much less than that of group A ( P<0.05);Liver function indexes 1 week after operation in group B and group C were superior to group A (P<0.05);The occurrence of complictions were 43.8%,14.3%and 15.6%in group A,group B and group C (P<0.05).Conclusion Biliary stent insertion via ERCP and traditional operation have similar efficacy for malignant biliary obstruction.ERCP has less complication and faster recovery of liver function.Biliateral metal stent drainage via ERCP has ideal effect of drainage.