经皮穿肝胆道引流(PTBD)结合经动脉灌注化疗(TAI)治疗胰头癌伴梗阻性黄疸  

Percutaneous transhepatic biliary drainage(PTBD)combined with transarterial infusion(TAI)in treatment of pancreatic head cancer with obstructive jaundice

作　　者：李长煜[1,2] 王小林[1,2] 龚高全[1,2] 程洁敏[1,2] 李国平[1,2] 刘凌晓[1,2] 施惠斌[1,2] 陈颐[1,2] 

机构地区：[1]复旦大学附属中山医院介入治疗科,上海200032 [2]上海市影像医学研究所,上海200032

出　　处：《复旦学报（医学版）》2014年第2期222-226,共5页Fudan University Journal of Medical Sciences

基　　金：上海市级医院新兴前沿技术项目(SHDC12010120)~~

摘　　要：目的 评价经皮穿肝胆道引流（percutaneous transhepatic biliary drainage,PTBD）结合经动脉灌注化疗（transarterial infusion,TAI）治疗中晚期胰头癌伴梗阻性黄疸的临床价值。方法 回顾性收集伴有梗阻性黄疸的胰头癌患者 28例,所有患者均先行PTBD解除胆道梗阻症状,待有效引流后行经动脉灌注化疗。分析患者的临床受益反应（clinical benefit response,CBR）、支架通畅时间、生存期和并发症。结果 28例患者共行PTBD 28次,胆红素由术前（168.9±64.1） μmol/L降到术后最低（37.2±6.2） μmol/L,其中15例放置胆道支架,支架平均通畅时间为10.6个月,共接受经动脉灌注化疗 81次,所有病例均未出现Ⅲ-Ⅳ不良反应,总临床受益反应为64.3%,平均生存期7.07个月。结论 PTBD结合经动脉灌注化疗是治疗中晚期胰头癌伴梗阻性黄疸患者安全可行的办法。Objective To evaluate the clinical value of percutaneous transhepatic biliary drainage （PTBD） combined with trans-arterial infusion （TAI） as the treatment for advanced or metastatic pancreatic head cancer with obstructive jaundice.Methods Twenty-eight patients who had been diagnosed with pancreatic head cancer with obstructive jaundice were analyzed retrospectively.All the patients underwent transarterial infusion of gemcitabine after effective drainage by PTBD.Clinical outcomes including clinical benefit response （CBR）,stent patency time,overall survival （OS）,and complications were evaluated.Results In 28 patients,total serum bilirubin was decreased from （168.9±64.1） μmol/L to （37.2±6.2） μmol/L after PTBD.Among them 15 received stent implantation whose mean stent patency time was 10.6 months.Totally 81 times of trans-arterial infusions were done without Ⅲ-Ⅳ adverse reactions,the proportion of clinical benefit response was 64.3% and mean overall survival was 7.07 months.Conclusions PTBD combined with TAI is a safe and feasible therapy for locally advanced or metastatic pancreatic head cancer with obstructive jaundice.

关 键 词：胰腺癌 梗阻性黄疸 经皮穿肝胆道引流(PTBD) 经动脉灌注化疗(TAI) 

分 类 号：R735.9[医药卫生—肿瘤]