关键词: 恶性梗阻性黄疸, 经皮肝穿刺胆道引流, 体外辅助胆汁入肠, 治疗

Abstract: Objective The aim of this study was to observe the alleviative treatment of percutaneous transhepatic biliary drainage (PTBD) and auxiliary bile entering to gut in treatment of patients with malignant obstructive jaundice. Methods A total of 100 patients with malignant obstructive jaundice, including bile duct cancer in 42 cases, pancreatic cancer in 35 cases and gallbladder cancer in 23 cases, were encountered in our hospital between September 2019 and September 2022, and were randomly divided into control group (n=50) and observation group (n=50), receiving PTBD alone, or the auxiliary bile entering to gut at base of PTBD treatment. Blood parameters were detected by PUZS-600A automatic biochemical analyzer. Results At the end of two week treatment, the body mass index, blood sodium, blood potassium and serum albumin levels in the observation group were(20.3±2.2)kg/m², (144.8±14.6)mmol/L, (4.6±0.5)mmol/L and (35.2±4.2)g/L, significantly higher than [(16.9±1.8)kg/m²,(138.2±10.7)mmol/L, (4.3±0.4)mmol/L and (30.1±4.9)g/L, respectively, P＜0.05] in the control; serum bilirubin, aspartate aminotransferase, alanine aminotransferase and glutamyl transpeptidase levels in the observation group were(142.5±34.5)μmol/L, (42.7±18.6)U/L, (45.9±12.9)U/L and (215.2±74.3)U/L, all significantly lower than [(172.3±36.8)μmol/L, (58.4±14.4)U/L, (62.35±17.8)U/L and (271.9±62.1)U/L, respectively, P＜0.05] in the control; post-operationally, there were bile exosmosis in 5 cases, local catheterization site pain in 8 cases, diarrhea in 1 case and biliary peritonitis in 1 case in the observation group, and there were bile exosmosis in 6 cases, local catheterization site pain in 11 cases and biliary peritonitis in 3 cases in the control, without significant difference between the two groups (30.0% vs. 40.0%, P＞0.05). Conclusion The application of PTBD and auxiliary bile entering to gut in the treatment of patients with malignant obstructive jaundice could relief transiently hyperbilirubinemia and improve the nutritional status, which warrants further clinical investigation.

Key words: Malignant obstructive jaundice, Percutaneous transhepatic biliary drainage, Auxiliary bile entering to gut, therapy