超声定位下经皮肝胆管穿刺置管术治疗恶性肿瘤致胆道梗阻的疗效分析

史振军 方嘉峰 黄水才

【摘要】 目的 探究分析超聲定位下经皮肝胆管穿刺置管术治疗恶性肿瘤致胆道梗阻的疗效及对患者生活质量的影响。方法 70例恶性肿瘤致胆道梗阻患者， 根据双盲法将其分为甲组和乙组， 每组35例。甲组实施外科手术， 乙组实施超声定位下经皮肝胆管穿刺置管术。比较两组患者治疗效果以及手术前后的各项生化指标[总胆红素（TBIL）、直接胆红素（DBIL）、白蛋白（ALB）、前白蛋白（PA）]水平、生活质量（QOL）评分。结果 乙组治疗总有效率97.1%高于甲组的80.0%， 差异具有统计学意义（P<0.05）。手术后， 两组患者TBIL、DBIL、ALB、PA水平均有所改善， 且乙组患者TBIL水平（57.2±7.6）μmol/L、DBIL水平（34.2±5.1）μmol/L明显低于甲组的（102.7±7.8）、（69.8±10.2）μmol/L， ALB水平（36.1±1.0）g/L、PA水平（181.2±4.0）mg/L均高于甲组的（32.8±1.5）g/L、（172.3±3.7）mg/L， 差异均具有统计学意义（P<0.05）。两组患者QOL评分高于手术前， 且乙组患者QOL评分（44.5±4.2）分高于甲组的（34.0±3.9）分， 差异均具有统计学意义（P<0.05）。结论 相较于常规外科手术治疗， 超声定位下经皮肝胆管穿刺置管术治疗恶性肿瘤致胆道梗阻， 疗效、生化指标改善情况以及患者生活质量更为理想。

【关键词】 经皮肝胆管穿刺置管术;超声定位;外科手术;恶性肿瘤致胆道梗阻;临床疗效

DOI：10.14163/j.cnki.11-5547/r.2020.22.011

Effect analysis of percutaneous hepatobiliary catheterization guided by ultrasound on biliary obstruction caused by malignant tumor   SHI Zhen-jun， FANG Jia-feng， HUANG Shui-cai. Department One of Surgery， Guangzhou Traditional Chinese Medicine Hospital， Guangzhou 510130， China

【Abstract】 Objective   To investigate the efficacy of percutaneous hepatobiliary catheterization guided by ultrasound on biliary obstruction caused by malignant tumor， and its influence on quality of life of patients. Methods   A total of 70 patients with biliary obstruction caused by malignant tumor were divided into group A and group B by double-blind method， with 35 cases in each group. Group A was treated by surgery， and group B was treated by percutaneous hepatobiliary catheterization. The therapeutic effect， biochemical indexes [total bilirubin （TBIL）， direct bilirubin （DBIL）， albumin （ALB）， prealbumin （PA）] before and after surgery and quality of life （QOL） score were compared between the two groups. Results   The total effective rate 97.1% of group B was higher than that of group A 80.0%， and the difference was statistically significant （P<0.05）. After surgery， the levels of TBIL， DBIL， ALB and PA of the two groups were improved， and TBIL （57.2±7.6） μmol/L， DBIL （34.2±5.1） μmol/L of group B were obviously lower than those of group A （102.7±7.8）， （69.8±10.2） μmol/L， and ALB （36.1±1.0） g， PA （181.2±

4.0） mg/L were higher than those of group A （32.8±1.5） g， （172.3±3.7） mg/L. The difference was statistically significant （P<0.05）. QOL score of the two groups was higher than those before surgery， and QOL score （44.5±4.2） points of group B was higher than that of group A （34.0±3.9） points， and the difference was statistically significant （P<0.05）. Conclusion   Compared with conventional surgery， percutaneous hepatobiliary catheterization under ultrasound location is more ideal in the treatment of biliary obstruction caused by malignant tumor， with better curative effect， biochemical index improvement and quality of life of patients.