肝门部胆管癌的非切除性辅助治疗方式选择  

Choice of palliative measures for unresectable hilar cholangiocarcinoma

作　　者：陈东[1] 陈义雄[1] 冯友权[1] 周国英[1] 陈明[2] 

机构地区：[1]广东医学院附属医院放射科,广东湛江524001 [2]广东医学院附属医院肝胆外科,广东湛江524001

出　　处：《中国基层医药》2005年第5期584-585,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨肝门部胆管癌的非切除性辅助治疗方式。方法经皮肝胆管引流术(PTCD)22例(A组),其中12例放置金属内支架。胆肠吻合术29例(B组)。两组对胆管炎、引流管相关问题、黄疸、住院时间、是否用抗生素、止痛药六个参数进行评价,对1个月内生存质量进行评估。结果A组4例PTCD黄疸消退不明显或黄疸复发,B组仅3例黄疸消退不满意。A、B两组生存质量评估显示与引流管相关问题尤为明显(40.8%),其中PTCD5例,出现引流管滑移或阻塞,12例金属内支架一次性置入成功。结论金属内支架置入术是辅助治疗非切除性肝门部胆管癌的有效方法,其生存质量高于PTCD。Objective To investigate the palliative measures for unresectable hilar cholangiocarcinoma.Methods 51 cases of unresectable hilar cholabgiocarcinoma were managed by nonoperative(22 cases,group A),including percutanons transhepatic biliary draiage(PTCD) 10 cases,metallic stent implantation 12 cases,and operative options with cholangio-enteric bypass(29 cases,group B).The quality of life was evaluated according to the results of six objective parameters in a month,including cholangitis,catheterrelated problems,jaundice,hospitalization,antiboyic and analgesic.Results In 41 cases,jaundice reduced satisfactorily after the treatment.However,The results was unsatisfactory in 4 cases(group A,40%) with PTCD procedure,and in 3 cases(group B) with cholangioenteric bypass.The result of the overall assessment of the quality of surrivval was significantly relative to catheter-related problems(40.8%),including 10 cases in group A(50%) with the complication of the slipped or blocked catheters.Stent implantation was successful in 12 cases.Conclusion The metallic stent provides good and effective drainage for unresectable hilar cholangiocarcinoma.The patients with metallic stent had a higher quality of survival than with PTCD.

关 键 词：肝门部胆管癌 辅助治疗 切除性 方式选择 经皮肝胆管引流术 金属内支架置入术 胆-肠吻合术 生存质量评估 PTCD 引流管 治疗方式 住院时间 有效方法 胆管炎 黄疸 抗生素 止痛药 不满意 一次性 B组 相关 消退 

分 类 号：R735.8[医药卫生—肿瘤] R735.905[医药卫生—临床医学]