肝门部胆管癌不同胆汁引流方式的疗效分析  

Therapeutic effect of percutaneous transhepatic biliary drainage with different approaches in patients with hilar cholangiacarcinoma

作　　者：杨福玲[1] 苏洪英[1] 邵海波[1] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001

出　　处：《中国介入影像与治疗学》2010年第2期177-180,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家科技支撑计划课题(2007BAI05B06)

摘　　要：目的回顾性分析不同经皮经肝胆汁引流方式对BismuthⅡ～Ⅳ型肝门部胆管癌患者术后疗效的影响。方法97例BismuthⅡ～Ⅳ型肝门部胆管癌患者按照不同引流方式分组:单侧和双侧引流组,每组又分为支架引流和引流管引流,比较各引流方式的术后疗效。结果单、双侧引流组的近期总胆红素下降程度分级差异无统计学意义(P>0.05),中位生存期分别为7.5和6.7个月,生存率差异亦无统计学意义;单侧支架引流与引流管引流、单侧与双侧支架引流的中位生存期分别为6.0、6.5、6.0、4.3个月,组间生存率差异无统计学意义,但引流管组术后近远期并发症发生率高。结论对BismuthⅡ～Ⅳ型肝门部胆管癌患者可行单侧胆管引流以减轻黄疸,以胆管内支架治疗为首选,可获得满意临床疗效,且不影响近期胆红素下降和远期生存情况。Objective To evaluate the therapeutic effect of percutaneous transhepatic biliary drainage（7PTBD） with different approaches in patients with hilar cholangiocarcinoma type Ⅱ-Ⅳ.Methods The short-term clinical effect and long-term survival rate were analyzed retrospectively for a group of 97 patients with hilar cholangiocarcinoma type Ⅱ-Ⅳ receiving PTBD with different approaches,i.e.unilateral and bilateral biliary drainage,each including stent placement and drainage tube implantation.Results No significant difference was found in the decreasing of TBIL and DBIL,the survival rate and survival curve between unilateral and bilateral biliary drainage.The median survival time was 7.5 months in unilateral and 6.7 months in bilateral biliary drainage,6.0 months in single stent and 6.5 months in single drainage tube,and 4.3 months in bilateral stents,respectively.The post operation complications mainly occurred in single drainage tube.Conclusion Single biliary drainage is able to decrease bilirubin for hilar cholangiocarcinoma type Ⅱ-Ⅳ,while stent implantation should be taken as the first choice.

关 键 词：胆管癌 放射摄影术 介入性 疗效 

分 类 号：R735.8[医药卫生—肿瘤]