经皮肝穿刺胆管引流术联合调强放疗治疗恶性梗阻性黄疸的临床研究  

Clinical research of PTCD combined with IMRT in the treatment of malignant obstructive jaundice

作　　者：邰国梅[1] 蔡晶[1] 刘向阳[1] 赵季忠[1] 

机构地区：[1]江苏省南通市肿瘤医院放疗科,江苏南通226361

出　　处：《实用临床医药杂志》2014年第21期35-37,46,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321404)

摘　　要：目的观察经皮肝胆管穿刺引流术(PTCD)联合调强放疗(IMRT)治疗恶性梗阻性黄疸(MOJ)的疗效。方法采用PTCD联合IMRT治疗MOJ对照既往实施常规PTCD的患者,观察并比较二者疗效。结果观察组36例血清总胆红素(T-Bi L)在PTCD治疗后1周明显下降,IMRT治疗结束1个月后持续下降;经IMRT治疗后肿瘤总有效率72.22%;PTCD联合IMRT组6个月、1年、2年累积生存率分别是77.78%、55.56%和11.11%,明显高于既往单纯行PTCD的生存率(57.14%、23.81%、0%)(P<0.05)。2组的中位生存时间分别为18个月和9.2个月(P<0.05)。结论 PTCD联合IMRT治疗MOJ安全有效,明显缓解黄疸和疼痛症状,从而提高患者的生活质量。Objective To observe the efficacy of percutaneous transhepatic cholangial drainage （PTCD） combined with intensity modulated radiation therapy （IMRT） in the treatment of malignant obstructive jaundice （MOJ）. Methods 36 MOJ patients were treated with PTCD combined with IMRT, and effect of which was compared with patients performed with PTCD only. Results Serum total bilirubin （T-BiL） in 36 patients after 1 week treatment of PTCD decreased obviously and continuously declined 1 month after the treatment of IMRT. The total response rate after performed with IMRT was 72.22% and accumulate survival rates of 6 months, 1 year and 2 years in patients performed with PTCD combined with IMRT were 77.78%, 55.56% and 11. 11%, which were significantly higher than 57.14% , 23.81% and 0% of single PTCD （P 〈 0.05）. The median survival time was 18 months and 9.2 months respectively （P 〈0.05 ）. Conclusion PTCD combined with IMRT is effective and safe in the treatment of MOJ, which can obviously relieve jaundice and pain and improve the life quality of the patients.

关 键 词：恶性梗阻性黄疸 经皮肝穿刺胆管引流 调强放疗 

分 类 号：R442.4[医药卫生—诊断学]