恶性梗阻性黄疸的内支架及PCS化学药物治疗  

Malignant biliary obstruction treated with expandable metallic biliary endoprothesis (EMBE) and port catheter system (PCS) chemotherapy

作　　者：张福君[1] 吴沛宏[1] 黄金华[1] 陈林[1] 陈英梅[1] 李小霞[1] 陈月桂[1] 宝金良 

机构地区：[1]中山医科大学肿瘤防治中心影像介入科,广州510060 [2]广东省顺德市桂洲医院影像科

出　　处：《癌症》1999年第6期724-726,729,共4页Chinese Journal of Cancer

摘　　要：目的 :探讨恶性梗阻性黄疸的内支架植入术后 ,动脉药盒植入术局部治疗的价值。材料和方法 :3 6例均已不能或不宜行外科手术治疗的恶性梗阻性黄疸病人 ,其中肝门区肿瘤 2 5例 (肝门原发性肝癌 12例 ,肝门转移性肝癌 13例 ) ,胰头癌 7例 ,胆管癌 4例 ,随机分两组 ,一组为单纯内支架治疗 (EMBE) ;另一组为EMBE加PCS治疗组。先行经皮胆管引流内支架植入术 ,然后行动脉药盒 (PCS)植入术 ,再按肿瘤生物特性及药代动力特点 ,经药盒泵入化疗药物。结果 :3 6例中 3 1例胆管引流内支架植入术成功 ,其中之 13例行单纯胆道内支架植入术 ,18例在胆道内支架植入术基础上行PCS植入术 ,随访 1～ 12个月 ,EMBE组 :1～ 3个月内 6例 ( 5 0 % )出现再闭塞。 2～ 6个月内死亡 8例 ,占 6 1 5 % ,12个月内死亡 11例 ,占 84 6 %。EMBE +PCS组 4( 2 2 2 % ) 1～ 3个月后出现再闭塞 ,2～ 6个月内死亡 6例 ,占 3 3 3 % ,12个月内死亡 9例 ,占 5 0 0 %。两组再闭塞率及死亡率相比 ,经t检验 ,P值<0 0 1,EMBE +PCS组与EMBE组有显著差异性。结论 :恶性梗阻性黄疸EMBE加PCS治疗优于单纯EMBE组 。Objectve:To investigate the local value of placement of expandable metallic biliary endoprothesis(EMBE) and port catheter system (PCS) for the treatment of maligant biliary obstruction Methods:A total of 36 cases with maligant biliary obstruction conld not or did not suit for surgical treatment, including hepatic portal tumor 25 cases (12 with primary hepatocellular carciatic tumor, 13 with metastatic carcinoma), pancreatic carcinoma 7 cases, biliary carcinoma 4 cases, were divided into two groups in random One underwent EMBE, the other underwent both EMBE and PCS EMBE of percutaneous biliary drainage were placed in those patients first, then PCS were done according to characteristics of biology and pharmacoknetics Chemotherapeutic agents were infused through PCS Results:Thirty one cases were successfully placed EMBE of biliary drainage in 36 cases, amony them 13 cases underwent EMBE only, 18 cases underwent PCS on the base of EMBE Follow up time was 1 12 months In EMBE group:6 cases (50%) developed reobstruction in 1 3 months, 8 cases (61 5%) died in 2 6 months, 11 cases (84 6%) died in 12 months, In EMBE and PCS group:4 (50%) cases reobstructed after 1 3 months,6(33 3%) cases died in 2 6 months, 9 cases (50%) died in 12 months Results:EMBE combined with PCS is a more effective method compared with EMBE only in treatment of maligant biliary obstraction It is a better local therapy method The two groups have significant difference in reobstruction rate and mortality rate (P< 0 01) Conclusion:PCS in addition to EMBA is better than EBMA alone, for the treatment of malignant biliary obstruction It is a better local treatment method

关 键 词：梗阻性黄疸 内支架 动脉药盒 PCS 恶性肿瘤 

分 类 号：R730.53[医药卫生—肿瘤] R575.05[医药卫生—临床医学]