经皮肝穿刺胆道引流结合胆道支架置入治疗恶性梗阻性黄疸  

PTCD combined with biliary stent implantation for the treatment of malignant obstructive jaundice

作　　者：钟醒怀[1] 张自旺 唐灿[1] 韦彩群[1] 李娜[1] 

机构地区：[1]广西壮族自治区河池市人民医院放射介入治疗科,547000

出　　处：《实用医学影像杂志》2016年第3期205-208,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨经皮肝穿刺胆道引流（PTCD）结合胆道支架置入治疗恶性梗阻性黄疸的效果。方法选取2012年6月至2015年4月,我院临床确诊的56例恶性梗阻性黄疸患者为观察对象,其中42例患者先行PTCD,后置入胆道支架,14例直接置入胆道支架进行引流。结果 56例患者术后1周血清总胆红素,由术前的（326±89）μmol/L下降至（142±56）μmol/L,51例患者术后1个月血清总胆红素达到或接近正常水平,5例血清总胆红素降幅度〈50%;术后1个月随访56患者中缓解黄疸的比率为82%;从2个月至3年随访可知,患者生存时间为8-28个月,中位生存期为17.3个月。结论 PTCD结合胆道支架置入治疗梗阻性黄疸的效果确切,可以延长患者生命并提高其生活质量,具临床可行性。Objective To investigate the effect of PTCD combined with biliary stent implantation in the treat-ment of malignant obstructive jaundice. Methods Fifty-six patients with obstruction jaundice from June 2012 to April 2015 were collected, of which 42 patients firstly underwent PTCD （percutaneous transhepatic biliary drainage）, then were implanted into biliary stent, 14 cases directly were implanted with biliary stent drainage. Results The serum total bilirubin of 56 cases postoperatively after a week were showed as follows ,the serum total bilirubin were detected as （326 ±89） mol/L preoperatively while （142 ±56） mol/L postoperatively, 51 cases′serum total bilirubin were close to normal levels, 5 cases′serum total bilirubin decrease〈50%;postoperative 1 month follow-up of 56 patients in remission of jaundice rate was 82%; during 2 months to 3 years follow-up it showed that, the survival time of patients were 8-28 months, with the median survival time of 17.3 months. Conclusion PTCD combined with biliary stent placement in the treatment of obstructive jaundice is effective, which can prolong the life of patients and improve their quality of life with clinical feasibility.

关 键 词：胆道外科手术 支架 黄疸 阻塞性 

分 类 号：R730.5[医药卫生—肿瘤]