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作 者:金涛[1] 江谋应 徐万里[1] 吕伟富 王金林[1] 方国全[1]
出 处:《安徽卫生职业技术学院学报》2007年第5期27-28,32,共3页Journal of Anhui Health Vocational & Technical College
摘 要:目的:报道国产金属胆道支架置入术治疗恶性阻塞性黄疸的初步经验。方法:12例患者均行PTC检查,了解胆管梗阻部位、程度和范围,然后在透视下选择性穿刺理想的肝管,引入导丝设法使其越过阻塞段后,交换硬导丝置入适宜的国产金属内支架。同时经支架内引入外引管,待支架扩张良好后撤除引流管。结果:12例患者共置入支架14枚,支架扩张满意。其中9例黄疸于2~4周完全消退,1例1周后死于肝肾综合症,2例术后2周自动出院失访。跟踪随访9例:4例存活5~7个月,3例存活11个月,另2例分别存活20个月、25个月,支架置入术后有8例患者分别进行了1~5次的介入化疗/栓塞。结论:经皮肝穿刺胆道支架引流术是治疗恶性阻塞性黄疸的有效的姑息性治疗方法,可明显缓解黄疸,提高患者的生存质量,结合介入化疗/栓塞可有限的延长患者生存时间。Objective To explore the initial experience of homemade metal biliary stent for the treatment of malignant obstructive jaundice. Methods 12 patients underwent PTC to check their, biliary obstruction location, extent and scope. Then under fluoroscopy their ideals were selectively punctured. Guide wire was introduced and made to cross the obstruction. Appropriate placement of homemade metal stent was made in exchange of hard guide. Mean whicl, the guidelines governing outside was introduced through the stent, and the drainage tube was removed after proper stent dilation. Results A total of 12 patients were put 14 stents, stent expansion is satisfing. Nine cases of jaundice in two-four weeks dissipated, one of them died a week after hepatorenal syndrome, two cases unable to contact after discharged. Nine cases were followed up 4 patients survived 5 - 7 months, 3 patients 11 months. Another two cases were alive for 20 months and 25 months ,Eight patients conducted 1 -5 times the TACE after stent implantation. Conclusion Percutaneous transhepatic biliary stent for the treatment of malignant obstructive jaundice is an effective palliative treatment. Jaundice can significantly ease and improve the life quality of patients. Plus chemotherapy / embolism can prolong survival time.
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