恶性胆道梗阻的联合介入治疗

Combined Radiological Intervention forMalignant Biliry Obstruction

为探讨多种介入治疗方法并用对恶性胆道梗阻病人的疗效，对３５例恶性胆道梗阻病人进行分析。３５例病人中１０例采用胆道外引流加局部动脉化疗栓塞治疗，１９例采用胆道外引流、支架植入及动脉化疗栓塞联合治疗，６例行外引流及胆管内保留灌注化疗治疗。结果：３５例胆道外引流及１９例支架植入均获成功，减黄效果显著。２９例动脉化疗栓塞病人显示了肯定的抗瘤效应，而６例胆管内保留灌注化疗病人未显示抗瘤作用。两者死亡病例平均生存期分别为８．５月和３．５月，两组比较有显著性差异（Ｐ＜０．０５）。结论：胆道支架植入和／或外引流与局部动脉化疗栓塞联合应用是治疗恶性胆道梗阻的安全有效的综合疗法。

To evaluate the effectiveness of combined interventional procedures for treatment of malignant biliary obstructions, we analysed 35 patients with nonresectable malignant biliary obstruction. Ten of them were treated with PTCD and transcatheter artery infusion chemotherapy or embolization (TAI/TAE), nineteen treated with PTCD, TAI/TAE and stent implantation; six treated with PTCD and intrabiliary infusion chemotherapy (BIC). The results showed that twentynine cases treated with TAI/TAE showed satisfactory anticancer results, nevertheless 6 cases treated with BIC showed no curative effects. In comparison of mean survival of died patients in two groups, statistic differences could be seen (8.5 months versus 3.5 months). The results suggest that stent implantation and/or PTCD combined with TAI/TAE is one of the safe and effective methods for treatment of malignant biliary obstructions. Effect of BIC is indefinite and further trials are needed.