国产镍钛支架治疗恶性胆道梗阻的临床分析

The treatment of malignant obstructive jaundice with placement of home-made nitinol stent in biliary duct

目的:探讨经皮肝穿胆道植入国产镍钛支架治疗恶性梗阻性黄疸的价值和临床效果。方法:在X线监视下,22例恶性梗阻性黄疸患者经皮肝穿植入国产镍钛合金自膨式裸支架24枚,恶性梗阻的原因分别为胆管细胞癌8例,胰头癌6例,肝癌3例,壶腹癌2例,肝门转移性病变3例。结果:22例患者共24枚支架全部成功植入,术后21例患者症状缓解,总胆红素明显降低。1例患者术后1天出血死亡,30天生存率为95.5%.4个月和7个月后分别有3枚支架堵塞,通过支架内支架和钢丝疏导解除。结论:国产镍钛合金自膨式裸支架性能良好,临床疗效满意。

Objective： To investigate the values and clinical effects of homemade self-expanding nitinol stentt for the treatment of malignant obstructive jaundice. Methods：22 patients with malignant biliary obstruction were treatment by means of perentaneous transhepatic biliary home-made nitinol stents placement, the malignant obstructions were due to inoperable primary carcinoma of the pancreas, livers, Vater＇s ampullae or bile ducts and regional lymphnode metastases. Results： Successftd deployment, correct positioning and patency of 24 stents were achieved in all 22 patients. Symptoms associated with biliary obstruction were relieved and the total serum belirubin decreased signitieanfly after the procedure in 21 patients. 1 patient died from bleeding in one day after the procedure. 30-day motality rate was 95.5%. 3 stents were occluded in 4 and 7 months respectively, and the occlusion were relieved by stent-in-stent and leading with steel wire. Conclusion：The property of home-made selfexppanding nitinol stentt is reliable and malignant biliary obstructions can be treated successfully by means of percntaneous transhepatic biliary home-made nitinol stents placement.