The Curative Effects And Related Factors Of PTCD And PTBS On The Treatment Of Malignant Obstructive Jaundice

Obstructive jaundice diagnosed during clinical usually has developed to the late, because the patient’s own situation to observe only the individual through surgical radical resection for treatment, while patients with surgical palliative resection and shunt bypass caused mortality and complication rate is very high. The implementation of the right intercostal puncture trocar in into the biliary tract and biliary decompression in complications decreased significantly in the1966British physician Seldinger; in1974, Okduda et al. Fine needle aspiration related technology was improved and the development, and the first successful without the outer after puncturing department to intervene in the case, was significantly reduced in patients with mortality and the incidence of postoperative complications. After the implementation of the skin biliary drainage in1974Stocknm and Molnar (PTCD) can effectively disease malignant obstructive jaundice for improvement and remission, in clinical palliative therapy of malignant obstructive jaundice, PTCD as the preferred means, so as not to take the bypass patients treated were divided flow provides decompression treatment scheme. Especially in recent years, with the extensive biliary stenting (and the continuous progress in the development of interventional therapy and interventional equipment), minimally invasive technology matured, the biliary stent implantation greatly improved success rate, improve the patient’s condition, treatment for further (such as liver TACE operation, internal radiation therapy, two-stage operation etc.) and create good conditions, raising the quality of life of patients, is expected to further lengthen the survival time. The main means of the current clinical biliary drainage and biliary stent implantation in the treatment of malignant obstructive jaundice, but the postoperative effect of drop causes yellow and its recovery has been the focus of clinicians. Objective:the aim of this paper is to investigate the clinical effect of biliary drainage and biliary stent implantation in the treatment of malignant obstructive jaundice, and analyze the patients at1weeks and4weeks after treatment, total bilirubin (TB) related factors decrease yellow effect on reducing the status and influence of patients, to provide the basis for improving the treatment of the clinical effect of malignant obstructive jaundice.Methods:In this paper the research object for the hospital in June2011-November2013treated with complete data of76patients with malignant obstructive jaundice, all patients were PTCD and bile duct carotid stenting,49cases (64.47%) of men, women and27cases (35.53%).21-79-year-old is the patient’s age range, the average age was (59.6+/-12.2). According to the patient’s implementation of PTCD and bile duct of carotid stenting for patients with postoperative fall yellow, and so on and so forth statistical regression analysis, to analyze its related factors, looking for patients with postoperative recovery in patients with relevance, to guide the clinical restoration and what factors related to postoperative patients.Results:PTCD and bile duct carotid stenting, all patients were successfully to implementation according to patients’condition in treatment, including outside using a total of12cases of the drainage tube, the proportion is15.79%, the implementation of the internal and external drainage tube, a total of37cases accounted for48.68%, the implementation of a total of27cases with bare metal stents, the proportion of35.53%. Placement equipment statistics are as follows:20,62root inside and outside the tube and the drainage tube46a bare metal stents.This research criteria for patients with postoperative1week and4weeks of total bilirubin (TB) level, the implementation of the various factors one-way analysis of variance, two groups of samples t test and bivariate correlation analysis. Through statistical analysis of observed that there are significant factors include jaundice patients before treatment, operation duration, before the operation the patient’s level of TB, before surgery in patients with liver function, patients with obstruction and infection status of1month after operation. Conclusion:the factors of PTCD and bile duct stent in patients after successful reduction of Huang1in the1week of August rate impact mainly includes:the treatment, stenosis patients, liver function in patients with preoperative patients with obstruction, patients, preoperative TB level, the patients before Huang Danchi continued infection1months after operation, the patients. The rapid recovery of patients condition for the main characteristics:non hepatic portal area, in the preoperative liver function tests for Child-Pugh class B, did not complete obstruction, malignant obstructive jaundice after MOJ stenting. Patient characteristics and the slow recovery of operation:before jaundice for longer duration, in its operation before the operation, and high levels of TB occurred1months after infection.