胆管内支架治疗高龄恶性梗阻性黄疸的临床研究

Clinical Study on Treatment with Endobiliary Stent for Elderly Patients with Malignant Obstructive Jaundice

目的探讨胆管内支架治疗高龄恶性梗阻性黄疸(MOJ)的临床疗效及安全性。方法对2006年1月至2011年12月到牡丹江医学院第二附属医院就治的63例80岁以上高龄MOJ患者,行丙泊酚静脉麻醉下胆管内支架引流术治疗。结果 63例患者均成功放置胆管内支架,其中1例术后第8天支架移位,取出后重新放置;术后3周时患者总胆红素由术前的(189.6±21.7)μmol/L降为(33.8±9.7)μmol/L;术后2～3周患者黄疸均明显消退,皮肤瘙痒症状消失,近期疗效显著;术后7例患者出现并发症。结论胆管内支架引流术治疗高龄MOJ疗效肯定,采用丙泊酚静脉麻醉安全可靠。

Objective To explore the clinical effect and the safety of the treatment with endobiliary stent for elderly patients with malignant obstructive jaundice（MOJ）. Methods 63 patients with MOJ over eighty years from the Second Affiliated Hospital of Mudanjiang Medical College from Jan. 2006 to Dec. 2011 were given the operation of endobiliary stent drainage under intravenous anesthesia with propofol. Results Endohiliary stents were imbedded for the 63 cases successfully,and only one of which was re- placed at the 8th day after the operation since the stent shifted. At the 3rd weeks after operation, total bilila- bin level was decreased from （ 189.6 ± 21.7 ） Ixmol/L before operation to （ 33.8± 9.7 ） Ixmol/L. 2-3 weeks after operation all patients＇ jaundice apparently disappeared,and skin itch was missing. The short- term effect was significant. 7 cases were found to have postoperative complications. Conclusion The ther- apeutic effect is affirmative when the treatment with cndobiliary stent drainage is used for elderly patients with MOJ. It is safe to conduct intravenous anesthesia with propofol during the operation.