[1]张 蓓,答秀维,张 乐△.经皮肝穿刺胆道外引流治疗恶性梗阻性黄疸疗效及对患者细胞免疫功能、血清直接胆红素、超敏C反应蛋白水平的影响*[J].陕西医学杂志,2020,49(10):1249-1252.[doi:DOI:10.3969/j.issn.1000-7377.2020.10.012]
　ZHANG Bei,DA Xiuwei,ZHANG Le..Curative effect of percutaneous transhepatic cholangial drainage in treatment of malignant obstructive jaundice and the influence on cellular immune function,serum DBIL and hs-CRP levels[J].,2020,49(10):1249-1252.[doi:DOI:10.3969/j.issn.1000-7377.2020.10.012]
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经皮肝穿刺胆道外引流治疗恶性梗阻性黄疸疗效及对患者细胞免疫功能、血清直接胆红素、超敏C反应蛋白水平的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年10期
页码:
1249-1252
栏目:
临床研究
出版日期:
2020-10-05

文章信息/Info

Title:
Curative effect of percutaneous transhepatic cholangial drainage in treatment of malignant obstructive jaundice and the influence on cellular immune function,serum DBIL and hs-CRP levels
作者:
张 蓓; 答秀维; 张 乐△
空军军医大学唐都医院疼痛科(西安 710038)
Author(s):
ZHANG Bei; DA Xiuwei; ZHANG Le.
Department of Pain,the Tangdu Hospital of Air Force Medical University(Xi'an 710038)
关键词:
经皮肝穿刺胆道外引流;  恶性梗阻性黄疸;  免疫功能;  直接胆红素;  超敏C反应蛋白
Keywords:
Percutaneous transhepatic cholangial drainage;  Malignant obstructive jaundice;  Immune function;  Direct bilirubin;  Hypersensitive C reactive protein
分类号:
R657.4
DOI:
DOI:10.3969/j.issn.1000-7377.2020.10.012
文献标志码:
A
摘要:
目的:探讨经皮肝穿刺胆道外引流术(PTCD)治疗恶性梗阻性黄疸(MOJ)疗效及对细胞免疫功能、血清直接胆红素(DBIL)、超敏C反应蛋白(hs-CRP)水平的影响。方法: 选取96例MOJ患者作为研究对象,依据随机数字表法将96例患者随机分为两组,分别为观察组和对照组各48例。其中对照组采用开腹手术引流治疗,观察组采用PTCD介入治疗,比较两组术后1周的治疗总有效率,以及术前和术后1周的肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、直接胆红素(DBIL)、总胆红素(TBIL)]、超敏-C反应蛋白(hs-CRP)、细胞免疫指标[CD3+、CD4+、CD4+/CD8+]以及术后3个月期间的并发症发生率。结果:经治疗,观察组的总有效率91.67%比对照组的75.00%明显更高(P<0.05); 观察组DBIL、TBIL、hs-CRP均低于对照组(P<0.05); 观察组CD3+、CD4+占比和CD4+/CD8+均比对照组更高(P<0.05); 但两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:采用PTCD治疗MOJ患者具有较好的治疗疗效,可明显降低血清DBIL和hs-CRP水平,并改善患者细胞免疫功能。
Abstract:
Objective:To explore the curative effect of percutaneous transhepatic cholangial drainage(PTCD)in the treatment of malignant obstructive jaundice(MOJ)and the influence on cellular immune function,serum direct bilirubin(DBIL)and hypersensitive C reactive protein(hs-CRP)levels.Methods:A total of 96 patients with MOJ were selected and divided into observation group(48 cases)and control group(48 cases)by the random number table method.The control group was treated with laparotomy and drainage,and the observation group was treated with PTCD interventional treatment.The total effective rate at 1 week after operation,liver function indexes [alanine aminotransferase(ALT),aspartate aminotransferase(AST),DBIL,total bilirubin(TBIL)],hs-CRP and cellular immune indexes(CD3+,CD4+,CD4+/CD8+)before operation and at 1 week after operation,incidence of complications in 3 months after operation were compared between the two groups.Results:After treatment,the total effective rate in the observation group was significantly higher than that in the control group(91.67% vs.75.00%,P<0.05).The levels of DBIL,TBIL and hs-CRP in the observation group were lower than those in the control group(P<0.05),while the levels of CD3+,CD4+ and CD4+/CD8+ were higher than those in the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:PTCD is effective in treatment of MOJ.It can significantly reduce serum DBIL and hs-CRP levels,and improve the patient's cellular immune function.

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备注/Memo

备注/Memo:
*空军军医大学唐都医院科技创新发展基金资助项目(2018LCYJ013)
更新日期/Last Update: 2020-10-10