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中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 560 -562. doi: 10.3877/cma.j.issn.1674-3946.2019.06.007.

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论著

腹腔镜根治术治疗Bismuth Ⅰ型肝门部胆管癌的引流术式选择及Apgar评分比较
陈智全1,(), 刘学军1   
  1. 1. 843000 新疆省阿克苏市阿克苏地区第一人民医院普外一科
  • 收稿日期:2019-01-23 出版日期:2019-12-26
  • 通信作者: 陈智全

Options of preoperative biliary drainage and Apgar scores of patients with Bismuth Ⅰ hilar cholangiocarcinoma who received laparoscopic radical surgery

Zhiquan Chen1,(), Xuejun Liu1   

  1. 1. Department of General Surgery (Ward I), the first people’s Hospital of Aksu District, Xinjiang 843000, China
  • Received:2019-01-23 Published:2019-12-26
  • Corresponding author: Zhiquan Chen
  • About author:
    Corresponding author: Chen Zhiquan, Email:
引用本文:

陈智全, 刘学军. 腹腔镜根治术治疗Bismuth Ⅰ型肝门部胆管癌的引流术式选择及Apgar评分比较[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(06): 560-562.

Zhiquan Chen, Xuejun Liu. Options of preoperative biliary drainage and Apgar scores of patients with Bismuth Ⅰ hilar cholangiocarcinoma who received laparoscopic radical surgery[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 560-562.

目的

探究腹腔镜根治术治疗Bismuth Ⅰ型肝门部胆管癌(HCCA)的引流术式选择及Apgar评分。

方法

回顾性分析2008年7月至2015年7月收治的58例行腹腔镜根治术治疗的Bismuth Ⅰ型HCCA患者资料,根据术前引流方式不同分为两组,30例患者采用经皮肝穿刺胆道引流(PTBD)为PTBD组,28例患者采用经逆行胰胆管造影(ERCP)内支架引流为ERCP组。采用SPSS21.0软件进行分析,其中引流效果、Apgar评分等均以(±s)描述,采用独立t检验;操作成功率和并发症发生率采用χ2检验;P<0.05差异有统计学意义。

结果

PTBD组患者的平均术前引流时间、平均更换引流物次数等引流效果均少于ERCP组(P<0.05),而两组患者的引流后血清胆红素水平差异无统计学意义(P>0.05);PTBD组患者治疗后的Apgar评分高于ERCP组患者(P<0.05),胆道感染发生率低于ERCP组患者(P<0.05)。

结论

术前采用PTBD作为腹腔镜根治术的引流术式,引流效果更好,可显著改善患者的Apgar评分,降低术后胆道感染发生率,值得临床推广应用。

Objective

To investigate the preoperative biliary drainage and Apgar scores of patients with Bismuth Ⅰ hilar cholangiocarcinoma who received laparoscopic radical surgery.

Methods

Retrospective analysis were performed in 58 patients with Bismuth type I hilar cholangiocarcinoma who underwent laparoscopic radical surgery from July 2008 to July 2015. According to the different preoperative drainages, 30 patients in the PTBD group underwent percutaneous transhepatic biliary drainage (PTBD), while 28 patients in the ERCP group underwent endoscopic retrograde cholangiopancreatography (ERCP). The statistical analysis was performed by using SPSS21.0 software. Measurement data such as drainage effect and Apgar scores were expressed as mean ± standard deviation and were examined by independent t test. The operation success rate and complication rate were described by (n, %) and were examined by chi square test. A P value of <0.05 was considered as statistically significant.

Results

The drainage indexs of PTBD group were better than those of ERCP group respectively (P<0.05), however there was no significant difference in serum bilirubin level between two groups (P>0.05); the Apgar score of PTBD group was higher than that of ERCP group (P<0.05), and the incidence of biliary tract infection was lower than that of ERCP group (P<0.05).

Conclusion

Preoperative PTBD in laparoscopic radical surgery for hilar cholangiocarcinoma has better drainage effect, which could significantly improve the patient’s Apgar score and reduce the incidence of postoperative biliary tract infection. It is worthy of clinical application.

表1 58例HCCA患者根据不同术前引流方式两组患者基线资料比较[(±s),例]
表2 58例HCCA患者不同术前引流方式两组患者引流效果相关指标比较(±s)
表3 58例HCCA患者不同术前引流方式两组引流操作成功率与Apgar评分比较(±s)
表4 58例HCCA患者不同术前引流方式两组术后并发症情况比较[例(%)]
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