经内镜置放胆道支架治疗恶性梗阻性黄疸的疗效分析

Evaluation on endoscopic retrograde biliary stent for treating malignant obstructive jaundice

目的:探讨内镜下胆道支架置入治疗恶性梗阻性黄疸的疗效和安全性。方法:回顾性分析我院2002年1月～2005年12月经内镜置放胆道支架治疗恶性梗阻性黄疸26例的临床资料。结果:一次置放成功者24例(其中置放胆管金属支架14例,圣诞树支架10例),成功率92%。血清总胆红素由术前的(316.68±105.12)μmol/L下降为术后1周的(147.89±58.07)μmol/L,黄疸明显减轻,肝功能改善。24例均随访至死亡发现胆道金属支架平均保持通畅的时间185 d,圣诞树支架平均保持通畅的时间189 d,两者无明显差别。生存时间3～15个月。结论:经内镜置放胆道支架是治疗恶性梗阻性黄疸的一个创伤小、安全性好、并发症少的有效方法,并能提高患者生活质量及延长生存时间。

Objective：To evaluate the safety and treatment effect by endoscopic retrograde biliary stent placement drainage （ERBD） for malignant obstructive jaundice（MOJ ）. Methods： Medical records and history of the patients undergone ERBD treatment for MOJ from January 2002 to December 2005 were studied retrospectively. Results ： 24 out of the 26 （92 % ） patients successfully underwent ERBD（ 14 cases were placed biliary metal stem; 10 cases were placed Christmas-tree stent） and the serum total bilirubin content dropped from（316.68 ± 105.12） μmol/L to （147.89 ± 58.07） μmol/L within a week of the procedure with improved clinical symptoms. The follow-up revealed that the shortest patency support lasted for 73 days after placing the metal stent, with a maximum of 407 days and mean patency duration of 185 days. When the two stems were compared, there was no difference with the duration of patency. The patients survived from a minimum of 3 months to a maximum of 15 months after the treatment with a mean survival of 7.6 months. Conelusion ： ERBD is a round and effective treatment for MOJ with less invasion and complication. What＇s more, it can improve the quality of the patients＇ life and even prolong their life span.