金属内支架在老年人恶性胆道梗阻中的应用  

Application of metallic stents for malignant biliary obstruction in the elderly

作　　者：张永春[1] 于经瀛[1] 吴琼 韩京芬[1] 李果珍[1] 

机构地区：[1]卫生部北京医院

出　　处：《中华老年医学杂志》1999年第3期138-140,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨金属内支架置入术在老年人恶性胆道梗阻中的临床应用价值。方法采用细针经皮经肝胆道穿刺法，一次金属支架置入法。结果２７例中２２例置入金属内支架，穿刺成功率１００％，患者在１～３周后，总胆红素平均下降１３０μｍｏｌ／Ｌ，直接胆红素平均下降１１０μｍｏｌ／Ｌ，１２例生存６～１８个月（平均１０５个月）后死亡，１０例生存３周～１５个月，现健在；５例行胆道内外引流，生存３周～３个月（平均２６个月）。并发症：支架再梗阻３例，２例行再介入治疗；术中操作引起并发症３例。结论金属内支架置入术更适合年老体弱患者，可以替代外科姑息手术方法。Objective To evaluate the clinical application of metallic stents for malignant biliary obstruction in the elderly. Methods Implantation of metallic stents was carried out right after percutanous transhepatic and transcholedochal puncture with fine needle. Results The operation was successful in all the 22 patients,of whom 12 died 6 to 18 months (mean 10.5 months) after the operation and 10 survived from 3 weeks to 15 months.Five patients were treated by percutaneous transhepatic bile drainage because of financial problem and the survival period was shorter,being 3 weeks to 3 months(mean 26 months).Jaundice recurred 9 months after the operation in 3 patients and 2 were recanalized. Conclusions Implantation of metallic stents after percutaneous transhepatic and transcholedochal puncture with fine needle is feasible as a palliative treatment for malignant biliary obstruction in the elderly and is more acceptable than surgery in elderly patients.

关 键 词：胆道阻塞 肝外 介入性 放射学 老年人 治疗 

分 类 号：R657.43[医药卫生—外科学]