两种引流方法在胆总管结石伴梗阻性黄疸的应用比较

Comparison of two kinds of drainage methods in choledocholithiasis with obstructive jaundice

摘要:

目的 比较两种引流方法治疗胆总管结石伴梗阻性黄疸的疗效。方法 比较鼻胆管与鼻胆管联合持续负压吸引治疗胆总管结石伴梗阻性黄疸患者在内镜逆行胰胆管造影术（ERCP）术后3天血清总胆红素、直接胆红素、每日胆汁引流量及引流前后血清总胆红素差值和直接胆红素差值的差异。结果 鼻胆管联合持续负压吸引组血清总胆红素、直接胆红素下降、引流前后血清总胆红素差值、直接胆红素差值变化均优于鼻胆管组，且每日胆汁引流量明显多于鼻胆管组，差异均有统计学意义（P <0.05）。结论 鼻胆管联合持续负压吸引治疗胆总管结石所致梗阻性黄疸更有效，值得临床推广。

Abstract:

Objective To discuss which drainage method is more efficient in treatment of choledocholithiasis with obstructive jaundice. Methods Compared the difference of serum total bilirubin,direct bilirubin, the variation of serum total bilirubin and direct bilirubin before and after drainage and daily biliary drainage by endoscopic nasobiliary drainage (ENBD) and endoscopic nasobiliary drainage with continuous negative-pressure suction after three days. Results The daily biliary drainage about the patients by ENBD with continuous negative-pressure suction is much more effective than the patients by ENBD. The serum total bilirubin and direct bilirubin about the patients by ENBD with continuous negative-pressure suction is less than the patients by ENBD after three days. The variation of serum total bilirubin and direct bilirubin before and after drainage about the patients by ENBD with continuous negative-pressure suction is more than the patients by ENBD. Conclusion The ENBD with continuous negative-pressure suction is more effective for choledocholithiasis with obstructive jaundice.