内镜下置入金属支架对恶性胆道梗阻的姑息治疗  

Palliative therapy of malignant biliary obstruction(MBO) by endoscopic placement of metal stent (EPMS)

作　　者：李晓林[1] 崔毅[2] 李初俊[2] 梁碧云[1] 付茁[1] 

机构地区：[1]广东佛山市顺德区容奇医院,广东佛山528303 [2]中山大学附属第一医院,广东广州510080

出　　处：《中国内镜杂志》2005年第3期288-290,共3页China Journal of Endoscopy

摘　　要：目的评估内镜下置放金属胆道支架对恶性胆道梗阻患者姑息治疗的疗效。方法纳入病例为恶性疾病所致的梗阻性黄疸不能外科手术者。自2000年5月￣2003年11月共有21例患者接受了胆道金属支架放置术及随访观察。结果放置成功率与临床有效率分别是100%和95%,没有出现与手术相关的严重并发症。术后7d血清总胆红素平均下降70.8%,60d内的病死率为4.7%。支架置入后存活时间最短32d。有3例(14.3%)分别于术后90、168、850d发生支架阻塞,经ERCP确定为支架阻塞的3例患者均行塑料支架置入术,最长存活者已超过3年。结论对恶性胆道梗阻的姑息治疗,置入金属胆道支架较经皮经肝和外科手术引流创伤性小,并发症发生率低,可持久引流胆汁、改善临床症状,提高患者的生活质量,延长生存期,是一种安全、有效的选择。To evaluate the effect of palliative therapy of MBO by EPMS. Without surgical opportunity, 21 cases between May 2000 and November 2003 with obstructive jaundice caused by malignant diseases were treated by EPMS and closely followed up. The accomplished rate and effective rate were 100% and 95% respectively. No severe operation-related complication was present. The average reduction ratio of total bilirubin within 7 days was up to 70.8% posttherapeutically. The mortality rate within 60 days was 4.7%. The shortest survival time was 32 days after EPMS. Confirmed by Endoscopic retrograde choliangio-pancreatography (ERCP), 3 cases (accounted for 14.3%) of intrastent impaction occurred on the 90th ,168th, 850th day respectively after EMPS and all 3 cases received the treatment of endoscopic-guided plastic stent placement. The longest survival time has been more than 3 years. [Conclusions] Compared with other 2 palliative therapies of MBO: percutaneous hepatic drainage and surgical drainage, EPMS shows the following advantages: having little trauma and low complication rate ,suitable for persistent biliary drainage, improving clinical symptoms and quality of life of the patients ,prolonging lifespan. It is a secure and effective management for MBO.

关 键 词：支架 恶性胆道梗阻 姑息治疗 

分 类 号：R735.8[医药卫生—肿瘤]