PTCD及金属支架植入配合超选择动脉灌注化疗治疗恶性梗阻性黄疸的临床效果观察  

Clinical observation of PTCD and metal stent implantation combined with superselective arterial infusion chemotherapy in the treatment of malignant obstructive jaundice

作　　者：许哲 徐明林 赵健宇 XU Zhe;XU Ming-lin;ZHAO Jian-yu(Interventional Department,Hulunbuir People's Hospital,Hulunbuir 021008,China)

机构地区：[1]呼伦贝尔市人民医院介入科,021008

出　　处：《中国实用医药》2022年第16期23-26,共4页China Practical Medicine

摘　　要：目的探讨经皮肝穿刺胆道引流术(PTCD)及金属支架植入配合超选择动脉灌注化疗对恶性梗阻性黄疸的治疗效果。方法98例恶性梗阻性黄疸,均行PTCD及金属支架植入配合超选择动脉灌注化疗,观察治疗效果。结果98例患者均介入手术成功,介入手术成功率为100.00%,平均手术时间为(85.67±6.41)min,术后并发症发生率为10.20%(10/98),平均住院时间为(18.6±8.2)d。术后患者总胆红素、直接胆红素水平明显下降。结论PTCD联合金属支架植入治疗恶性梗阻性黄疸的效果显著,能有效地改善患者的临床症状,降低胆红素水平,且术后并发症发生率较低。配合超选择动脉灌注化疗可抑制患者局部肿瘤的生长,改善黄疸症状,延长胆道通畅时间,促进肝功能改善,同时患者生存质量有所提高,既可减轻患者经济负担,又能提高医疗资源利用效率,患者生存时间得到有效延长,在临床治疗中值得优先选择。Objective To discuss the therapeutic effect of percutaneous transhepatic cholangial drainage(PTCD)and metal stent implantation combined with superselective arterial infusion chemotherapy in the treatment of malignant obstructive jaundice.Methods All 98 cases of malignant obstructive jaundice were treated with PTCD and metal stent implantation combined with superselective arterial infusion chemotherapy,and their therapeutic effect was observed.Results The interventional surgery was successful in 98 patients,with a success rate of 100.00%,a mean operation time of(85.67±6.41)min,a postoperative complication rate of 10.20%(10/98),and a mean hospitalization time of(18.6±8.2)d.The total bilirubin and direct bilirubin levels decreased significantly in the patients after surgery.Conclusion PTCD combined with metal stent implantation has a significant effect in the treatment of malignant obstructive jaundice,can effectively improve the clinical symptoms of patients,reduce the level of bilirubin,and the incidence of postoperative complications is low.Combined with superselective arterial perfusion chemotherapy can inhibit the growth of local tumor,improve jaundice symptoms,prolong biliary patency time,and promote liver function improvement,while patient survival quality is improved,which can reduce the economic burden of patients and improve the efficiency of medical resources utilization,and the survival time of patients has been effectively prolonged,which is worthy of preference in clinical treatment.

关 键 词：经皮肝穿刺胆道引流术 恶性梗阻性黄疸 金属支架 超选择动脉灌注化疗 胆管阻塞 

分 类 号：R575[医药卫生—消化系统]