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目的:比较经皮经肝胆管引流术(PTCD)内外联合引流术与单纯外引流术治疗恶性梗阻性黄疸的疗效及并发症。方法:回顾性分析我院恶性梗阻性黄疸病例78例,分析采用不同术式的两组病例术前术后血清总胆红素、白蛋白、白细胞总数的水平变化。结果:两组病例术后第3天及第1个月血清总胆红素下降水平较术前差异有统计学意义。两组病例术前术后血清白蛋白变化差异均无统计学意义,术后1个月白细胞总数较术前有所下降,但多数未达到正常水平,且两组之间差异有统计学意义。结论:内外联合引流术早期降黄效果优于单纯外引流术,1个月后两者的降黄效果相当。PTCD术后的早期感染可能与操作本身相关,而后期的感染则可能与胆汁返流相关。
OBJECTIVE: To compare the efficacy and complications of percutaneous transhepatic biliary drainage (PTCD) combined with external drainage and external drainage in the treatment of malignant obstructive jaundice. Methods: A retrospective analysis of 78 cases of malignant obstructive jaundice in our hospital, analysis of the two groups using different surgical preoperative and postoperative serum total bilirubin, albumin, total white blood cells level changes. Results: The levels of serum total bilirubin in the two groups were significantly different from those before operation on the third day and the first month after operation. There was no significant difference in serum albumin between the two groups before operation and after operation. The total number of white blood cells in one month after operation was decreased, but most of the patients did not reach the normal level. There was a significant difference between the two groups. Conclusion: The internal and external drainage combined with drainage is superior to simple external drainage in the early stage of yellowing, and the effect of yellowing is similar after 1 month. Early infection after PTCD may be related to the operation itself, while later infection may be related to bile reflux.