经PTCD途径胆道金属支架置入术治疗恶性梗阻性黄疸137例临床疗效分析

Analysis of clinical curative effect on 137 malignant obstructive jaundice patients with the treatment of metal biliary stent placement by PTCD

目的探讨经皮经肝胆道引流(PTCD)后置入胆道金属支架姑息性治疗恶性梗阻性黄疸的临床应用价值。方法对137例失去根治性手术机会或不愿行手术治疗的恶性梗阻性黄疸患者,在超声引下行PTCD,术后1周在DSA下经PTCD窦道置入胆道金属支架,经此途径将体外引流转换为内引流。结果 137例患者术前血清总胆红素水平为(274.7±151.5)μmol/L,术后1周血清总胆红素下降到(150.1±100.6)μmol/L(P<0.01),肝功能明显改善(P<0.01),术后平均生存时间为(9.29±0.77)个月。结论经PTCD途径胆道金属支架置入术是一种治疗恶性梗阻性黄疸的有效方法,可明显延长患者生存时间、改善生活质量,具有安全、简便、创伤小、可重复等优点。

Objective Discussion on the clinical application value of implant biliary metal stents by PTCD to cure malignant obstructive jaundice. Method Do PTCD under the guidance of ultrasound, and then implant biliary metal stents by PTCD sinus, convert external drainage to internal drainage. Results Before the operation, serum total bilirubin of 137 cases is （274.7±151.5）μmol/L, and one week after the operation, serum total bilirubiu fell to 150.1±100.6）μmol/L （P 〈0. 01 ） ,liver function is improved obviously（ P 〈 0. 01 ）. Conclusion Implant biliary metal stents by PTCD is a effective method to cure malignant obstructive jaundice. It can prolong survival time obviously, improve quality of life, and have many advantages, such as security ,simple ,small trayma ,repeatable and so on.