本文選題：惡性梗阻性黃疸　切入點：膽腸Roux-en-Y吻合術　出處：《寧夏醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的回顧性研究分析膽腸Roux-en-Y吻合術與膽腸(十二指腸)架橋內(nèi)引流術治療惡性梗阻性黃疸相關指標有無統(tǒng)計學差異,為惡性梗阻性黃疸患者行姑息治療時術式選擇提供有價值的參考。方法選取我院近10年(2003年至2013年)因惡性梗阻性黃疸行膽腸Roux-en-Y吻合術與膽腸(十二指腸)架橋內(nèi)引流術治療的惡性梗阻性黃疸患者共69例。運用統(tǒng)計學原理進行回顧性分析,比較兩種術式術前術后血清膽紅素變化、手術時間、術中出血量、住院天數(shù)、并發(fā)癥發(fā)生率有無統(tǒng)計學差異。結果膽腸Roux-en-Y吻合組患者和架橋內(nèi)引流組患者術后第7天血清膽紅素均明顯下降且有統(tǒng)計學差異(P0.05)。而且從第10天開始,架橋內(nèi)引流組血清膽紅素下降較膽腸吻合組更明顯且有統(tǒng)計學差異(P0.05)。膽腸Roux-en-Y吻合組和架橋內(nèi)引流組在手術時間、住院天數(shù)、術后生存時間無統(tǒng)計學差異(P0.05),兩組術式術中出血量有統(tǒng)計學差異(P0.05)。并發(fā)癥發(fā)生率無統(tǒng)計學差異(P0.05)。結論架橋內(nèi)引流術相比膽腸Roux-en-Y吻合術而言,其手術操作簡單,臨床恢復較快;,臨床近期效果肯定,遠期治療效果滿意,有其更為良好的治療效果,為膽胰腸內(nèi)引流術提供了又一種較為理想的術式。
[Abstract]:Objective to study retrospectively whether there are statistical differences between Roux-en-Y anastomosis of gallbladder and duodenal bridging drainage in the treatment of malignant obstructive jaundice. To provide a valuable reference for palliative treatment in patients with malignant obstructive jaundice methods during the last 10 years (2003-2013) due to malignant obstructive jaundice, choledochojejunostomy and biliary (duodenal) bridging were performed in our hospital. 69 cases of malignant obstructive jaundice were treated by internal drainage. The changes of serum bilirubin before and after operation, the time of operation, the amount of intraoperative bleeding, the days of hospitalization were compared. Results the serum bilirubin levels in Roux-en-Y anastomosis group and bridging internal drainage group were significantly decreased on the 7th day after operation, and there were significant differences in the incidence of complications (P 0.05), and from the 10th day after operation, there were significant differences in serum bilirubin levels between the two groups. The decrease of serum bilirubin in bridging drainage group was more obvious than that in choledochojejunostomy group (P 0.05). There was no significant difference in survival time between the two groups (P 0.05). There was no significant difference in the amount of intraoperative bleeding between the two groups (P 0.05). There was no significant difference in the incidence of complications (P 0.05). Conclusion compared with Roux-en-Y anastomosis, the procedure is simple. The clinical recovery is faster, the clinical short-term effect is positive, the long-term treatment effect is satisfactory, and has its better therapeutic effect, which provides another kind of more ideal operation for biliary and pancreatic enteric drainage.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R657.4

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本文編號：1645672