经皮肝穿刺胆道支架置入及引流术治疗梗阻性黄疸  

Percutaneous Biliary Stents Placement and Drainage for Treatment of Biliary Obstruction

作　　者：李郁芳[1] 叶容臻[1] 李宇东[1] 扬明宇[1] 李燕[1] 张静[1] 蒲湘漪 刘巍[2] 

机构地区：[1]北京航天总医院影像中心,北京100076 [2]中国协和医科大学北京协和医院放射科

出　　处：《实用放射学杂志》2007年第10期1378-1381,共4页Journal of Practical Radiology

摘　　要：目的探讨梗阻性黄疸经皮肝穿刺胆道支架置入及引流术的治疗方法与疗效。方法对44例胆道梗阻患者先行经皮肝穿刺胆道造影(PTC),如导丝不能越过阻塞段,则直接行外引流;如能越过阻塞段,则行支架置入或内外引流术。结果44例患者中6例单纯外引流;7例单纯内外引流;2例仅行PTC胆道造影而未行胆道引流;29例置入支架32枚,其中19例行支架置入+外引流,10例单纯支架置入。在有完整随访资料的16例中,术后1周血清总胆红素从术前(351±142.4)μmol/L降至(143.5±97.6)μmol/L,13例血清总胆红素1个月降到正常或接近正常水平,3例血清总胆红素1个月无明显下降(<50%)。死亡9例,生存时间3～21个月,中位生存期6.8个月。结论经皮肝穿刺胆道支架置入及引流术是治疗梗阻性黄疸的一种安全、有效的姑息性方法。Objective To retrospectively study the technique and therapeutic effect of percutaneous biliary stents placement or drainage in treating biliary obstruction. Methods Percutaneous transhepatic cholangiography （PTC） was performed in forty - four patients with biliary obstruction. The inner - outer draining catheter or metallic stent was placed into biliary tract if the regions of obstruction could be passed by guild wire after PTC,or the outer drainage could only be carried out if the regions of obstruction could not be passed. Results 32 metallic stents were placed in 29 patients, the outer drainage was performed in 6 patients and inner - outer drainage in 7 patients. Within the period of follow -up in 16 patients, the serum total bilirubin decreased from （351±142.4 ）μmol/L before the procedure to （143.5 ± 97.6 ）μmol/ L one week later after the procedure,the serum total bilirubin decreased to normal or near normal level in 13 cases one month later and no obvious decreased in 3 cases. 9 patients died after a median survival of 6.8 months （ range 3 - 21 months）. Conclusion Percutaneous biliary stents placement and drainage is a safe and effective palliative therapy for malignant biliary obstruction

关 键 词：梗阻性黄疸 胆道 支架 引流 

分 类 号：R575[医药卫生—消化系统] R815[医药卫生—内科学]