胆道支架联合经皮穿刺^(125)I粒子植入治疗胆管恶性梗阻性黄疸26例临床观察  

Treatment the bile duct malignant obstructive jaundice by biliary tract stent and percutaneous puncture ^(125)I particle implantation

作　　者：伍靖武[1] 谢岳云[1] 鲍忠平[1] 田秀荣[1] 肖华 贺梅英 王鸿智[1] 

机构地区：[1]解放军181医院肿瘤诊疗中心

出　　处：《实用医院临床杂志》2010年第4期52-55,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨B超导向经皮经肝胆道引流(Percutaneous transhepatic cholangial drainage,PTCD)术后支架置入联合125Ⅰ粒子植入治疗胆管恶性梗阻的临床价值。方法 26例胆管恶性梗阻患者运用B超导向PTCD胆道支架植入后,运用超声导向经皮经肝按照治疗计划系统(Treatment Plan System,TPS)进行125Ⅰ粒子植入。结果 26例患者超声导向穿刺置管均一次性完成,引流通畅,无并发症发生;支架开通时间2～13个月;术后血清总胆红素(TBIL)和丙氨酸氨基转移酶(ALT)均显著下降(P<0.01),18例显效,8例有效;4个月无局部进展生存率为73.1%,10个月无局部进展生存率为0;生存期2～26个月。结论胆道支架联合经皮经肝125Ⅰ粒子植入治疗胆管恶性梗阻是一种安全有效的治疗方法。Objective To expl or e t he cl ini cal val u e f or t r eat men t of t he bi l e duct ma l i gnant obs t r uct i ve j aun di ce by per - cut aneous t r anshepat i c chol angi al drai nage( PTCD)wi t h bi l i ar y t ra ct s t ent and。I par t i cle i mpl ant at i on gui d ed by ul tr as ound． Met hods 26 cas es bi l e duct ma l i gnant obs t r uct i v e j a undi c e pat i ent s we r e t r eat ed wi th PTCDgui ded by Bt ype ul t r asound．The bi li ar y t ra ct s t ent s we r e pl a ced pos t—operat i on of dr ai nage and t hen per cut aneous punct ur e i mpl an t at i on t he 1”I part i cl e acc or di ng t o t he t r e atment pl an sys t eml 7rPs )by ul t r as ound gui danc e．Re sul t s No compl i cat i on ha ppene d i n per eut aneous t r ans hepat i c punct ur e and bi l i ar y t ra ct s t ent impl ant at i on．The t ent ope n t i me Wa s be tween 2～1 3 mont hs ．The s er um t ot a l bi l i r ubi n(TBIL) and l ac t ami ne ami no t r ans f er i ng enzyme(ALT) decr eas ed aft er oper at i on( P<0．01)．18 pat ient s had ma rkedl y e ff e ct l ei ght pat ients had ef f e ct 。The s ur vi val r ate of no par t ly advancement i n f our mont hs wa s 73．1％，The s ur vi val r at e of no par t ly advance— me nt i n t en mont hs wa s 0．The s ur vival per i od wa s 2～26 mont hs ．Concl us i on Bi li ar y s t ent combi ni ng per cut aneous⋯I par t i — cl e i mpl an t at i on f or mal i gna nt bi li ar y obs t r uct i on i s a s af e and eff ect i ve t re a tment ．

关 键 词：胆道支架 经皮穿刺 125Ⅰ粒子植入治疗 胆管 恶性梗阻性黄疸 临床观察 percutaneous puncture stent biliary tract obstructive JAUNDICE bile duct 经皮经肝胆道引流 超声导向 治疗计划系统 血清总胆红素 生存率 氨基转移酶 Treatment 治疗方法 支架置入 

分 类 号：R4[医药卫生—临床医学]