恶性阻塞性黄疸并肝叶萎缩-肥大复合征的介入治疗

The Interventional Treatment of Malignant Obstructive Jaundice with Atrophy-Hypertrophy Complex

目的探讨恶性阻塞性黄疸(MOJ)合并肝叶萎缩-肥大复合征的患者行单侧胆道引流的临床疗效。方法回顾性分析本院2010年2月至2012年4月收治的32例MOJ合并肝叶萎缩-肥大复合征患者的临床资料,所有患者均接受经皮肝穿刺胆道引流术(PTCD),对萎缩肝叶胆管不予处理,仅引流代偿增生、肥大的肝叶胆管。分析治疗前后胆红素及转氨酶变化。结果所有患者行经皮穿刺胆道造影术(PTC)、内外引流术(内支架或引流管置入),技术成功率100%。共置入支架30枚。全部患者血总胆红素、转氨酶水平术前、术后统计学对比分析有显著差异。临床症状明显改善。结论对MOJ合并肝叶萎缩-肥大复合征的患者,萎缩肝叶阻塞的胆管可不予以处理,仅对代偿增生、肥大的肝叶所属的阻塞胆道行引流术,可达到功能学治愈,疗效明显,无不良反应发生。

Objective To investigate the clinical efficacy of unilateral biliary drainage treatment of malignant obstructive jaundice （MOJ） with atrophy-hypertrophy complex. Methods 32 patients with malignant obstructive jaundice with atrophy hypertrophy were treated at the our center between February 2010 and April 2012. All patients were accepted percutaneous transhepaticcholangial drainage （PTCD） , untreated the atrophy lobe biliary, only drainage the liver bile duct of compensatory hyperplasia and hypertrophy. Bilirubin and transaminase change before and after treatment was analyzed. Results All patients were performed with percutanecous transhepatic cholangiography with internal and external drainage （stent or drainage tube placement）. Technical success rate was 100%. Statistics contrast analysis between all patients blood total bilirubin, transaminase level preoperative and postoperative had significant differences. The clinical symptoms were improved obviously. Conclusion To patients who developc MOJ with ＂atrophy hypertrophy complex＂, the atrophy lobe biliary is untreated, only the liver bile duct of compensatory hyperplasia and hypertrophy is drainaged, which can reach function cure and has no obvious adverse reaction