改良经皮肝穿刺胆道支架置入术治疗老年梗阻性黄疸效果分析  

Effects of the Improved Percutaneous Biliary Stent Implantation in the Treatment of Elderly Patients with Obstructive Jaundice

作　　者：苏仁美 刘承兵 

机构地区：[1]上饶县人民医院普外科,江西上饶334100

出　　处：《长江大学学报（自科版）（下旬）》2016年第8期29-30,3,共2页Journal of Yangtze University

基　　金：江西省卫生厅科研计划(普通)课题(20167274)

摘　　要：目的:探讨分析改良经皮肝穿刺胆道支架置入术在治疗老年梗阻性黄疸中的效果。方法:选取医院2014年1月至2015年12月收治的老年恶性梗阻性黄疸患者60例作为研究对象,采用改良经皮肝穿刺胆道支架植入术。结果:60例患者穿刺成功率达100%,穿刺左叶胆管21例,穿刺右叶胆管30例,左叶右叶均进行胆管穿刺9例。患者进行引流管保留7d以上可进行胆道支架植入术。其中有55例患者自觉临床症状得到缓解。患者在进行胆道支架植入术后14d,白蛋白、碱性磷酸酶、丙氨酸转氨酶、胆红素、直接胆红素和间接胆红素等生化指标较手术前明显降低(P<0.05)。患者手术后出现胆道感染6例,发生急性胰腺炎5例,出现支架脱落移位1例。60例患者得到随访调查52例,随访时间在8d^12个月之间,平均随访时间为(8.4±1.2)月。随访发现,36例患者死亡,死亡原因为肿瘤扩散或者多脏器功能衰竭。24例患者存活。结论:改良经皮肝穿刺胆道支架植入术是一种治疗恶性梗阻性黄疸的有效方法,治疗方法简单,治疗效果良好,治疗安全性较高。Objective:To investigate the effects of improved percutaneous biliary stent implantation in the treatment of elderly patients with obstructive jaundice.Methods:60cases of the elderly patients with malignant obstruction jaundice in the People's Hospital of Shangrao County from 2014 to 2015had been selected as the subjects treated with the improved percutaneous biliary stent implantation.Results:The success rate of punctures was 100%for the 60 cases,21cases of punctures in the left lobe bile duct,30 cases in the right lobe bile duct and 9cases in both the left lobe and the right.Patients were treated with the biliary stent implantation after retaining drainage tubes for more than 7days.Among them,55 cases felt relieved from clinical symptoms.In the 14 th day after the biliary stent implantation,The biochemical indexes of the patients,such as albumin,alkaline phosphatase(ALP),alanine transaminase,bilirubin,direct bilirubin and indirect bilirubin were significantly lower after operations(P<0.05).There were 6patients suffering from biliary tract infection after operations,5patients from acute pancreatitis and 1patient from stent shedding.52 patients in 60 were followed up.The follow-up time was from 8days to 12 months,and the mean follow-up was(8.4±1.2)months.The follow-up showed that 36 patients died and the cause of death was tumor proliferation or multiple organ failure and 24 survived.Conclusion:The improved percutaneous biliary stent implantation is an effective method for treating malignant obstructive jaundice,which is simple and highly safe with a good therapeutic effect and is worth spreading in clinic.

关 键 词：改良经皮肝穿刺 胆道支架植入术 梗阻性黄疸 老年人 

分 类 号：R657.4[医药卫生—外科学]