改良中心静脉留置管在胰头癌胆道梗阻引流术中的应用  

Application of Improved Central Venous Catheter in Drainage in Obstruction of Biliary Tract in Carcinoma of Head of Pancreas

作　　者：梁跃 叶青山 蔡茂德 黄锡梅 

机构地区：[1]广东省高州市祥山医院肿瘤科,广东高州525200

出　　处：《中外医疗》2009年第24期12-13,共2页China & Foreign Medical Treatment

摘　　要：目的探讨改良中心静脉留置管在胰头癌胆道梗阻引流术中的可行性及实用性,为部分因经济困难无法置放胆道支架患者提供补救措施。方法利用自制多侧孔的超长中心静脉留置管代替既往的猪尾巴导管作长期胆道内外引流。结果胰头癌致胆道梗阻者8例均成功地将管置入到十二指肠升部,外引流全部通畅。4例(完全内引流到肿瘤严重恶化,生命终结)仅用内引流,1例内引流3个月后黄疸再度出现,改为内外引流后退黄,3例长期内外引流,全部病例随访到生命终结,生存时间从3～18个月不等,中位生存期为6.3个月。结论改良中心静脉留置管可作为胰头癌胆道梗阻长期引流术的材料,并可作为胰头癌胆道梗阻患者无法置放胆道支架者的一种补救措施。Objective To explore feasibility and practicality of application of improved central venous catheter in drainage in obstruction of biliary tract in carcinoma of head of pancreas,provid a salvage therapy for patients with financial straits or tumor cause can impossiblely accept putting biliary tract bracket.Methods Use ultralong central venous catheter with poly-lateral aperture we make on to replace pigtail-like catheter as long-term biliary tract internal and external drainage.Results Eight patients with biliary tract in carcinoma of head of pancreas were successfully putin improved central venous catheter to the asceding part of dodecadactylon, external drainages are all easy and smooth. 4 cases（completely internal drainage）only used internal drainage, 1 case jaundice appears again three months after internal drainage, and jaundice disappear after changing to external drainage, 3 cases always used internal and external drainage, all cases follow up to life terminal bouton, survival time range 18 months to 3 months, median survival time was 6.3 months.Conclusion Improved central venous catheter can be used as material in drainage in obstruction of biliary tract in carcinoma of head of pancreas, and as a salvage therapy for patients can impossiblely accept putting biliary tract bracket.

关 键 词：改良 中心静脉留置管 长期引流 补救措施 

分 类 号：R575[医药卫生—消化系统]