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目的分析经内镜鼻胆管引流术(ENBD)及经皮经肝穿刺胆管引流术(PTCD)两种方法在胆管癌患者中的临床疗效和安全性。方法肝门部胆管癌患者26例,按治疗方法分为ENBD组与PTCD组,各13例。比较两组引流成功率、肝功能及安全性。结果 ENBD组与PTCD组引流成功率分别为53.8%(7/13)、84.6%(11/13),两组比较差异无统计学意义(χ2=1.529,P>0.05)。PTCD组丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰基转移酶(GGT)、血清胆碱酯酶(CHE)、白蛋白(ALB)、血清胆醇(CHO)、总胆汁酸(TBA)水平与ENBD组比较,差异均有统计学意义(P<0.05)。两组胆道出血、感染及炎症发生率比较差异无统计学意义(χ2=1.599,P>0.05)。结论 ENBD与PTCD两种胆管引流术均具有一定的引流成功率,胆管癌级别越低,则引流成功率越高。两种方法安全性无差异。PTCD可有效缓解肝功能,有临床推广应用的价值。
Objective To analyze the clinical efficacy and safety of endoscopic nasobiliary drainage (ENBD) and percutaneous transhepatic biliary drainage (PTCD) in patients with cholangiocarcinoma. Methods Twenty-six patients with hilar cholangiocarcinoma were divided into ENBD group and PTCD group according to the method of treatment, with 13 cases in each group. The success rate of drainage, liver function and safety were compared between the two groups. Results The success rates of drainage in ENBD group and PTCD group were 53.8% (7/13) and 84.6% (11/13), respectively. There was no significant difference between the two groups (χ2 = 1.529, P> 0.05). PTCD group, ALT, AST, ALP, GGT, serum cholinesterase (CHE), white Compared with ENBD group, the levels of ALB, CHO and TBA were significantly different (P <0.05). There was no significant difference in the incidence of biliary tract hemorrhage, infection and inflammation between the two groups (χ2 = 1.599, P> 0.05). Conclusion Both ENBD and PTCD biliary drainage have a certain success rate of drainage, the lower the level of cholangiocarcinoma, the higher the success rate of drainage. No difference in safety between the two methods. PTCD can effectively relieve liver function, the clinical application of the value.