经皮胆管金属支架置入治疗高龄恶性梗阻性黄疸46例疗效分析

The effect of percutaneous biliary metal stent placement in the treatment of malignant obstructive jaundice in 46 cases

目的:探讨经皮肝胆管引流术(PTCD)联合胆管金属支架置入治疗高龄恶性梗阻性黄疸的临床疗效。方法:46例70岁以上的恶性梗阻性黄疸患者,在超声引下行PTCD,术后1周左右在数字减影血管造影系统下经PTCD窦道置入胆管金属支架,将体外引流转换为内引流。结果:46例患者PTCD术后血清总胆红素明显下降(P<0.01),肝功能明显改善(P<0.01),术后平均生存时间为(10.53±2.35)个月。结论:经PTCD途径联合胆管金属支架置入术是治疗高龄恶性梗阻性黄疸患者的有效方法,可改善生活质量,具有简便、安全、有效、创伤小、可反复应用等优点,可作为治疗高龄恶性梗阻性黄疸患者首选的方法。

Objective：To evaluate the clinical effects of percutaneous transhepatic cholangial drainage（PTCD） combined with biliary metal stent placement in the treatment of elderly patients with malignant obstructive jaundice. Methods： Fourty-six patients over 70 years old with malignant obstructive jaundice were treatedwith PTCD under the guidance of ultrasound. The biliary metal stent was implanted into PTCD sinus under digital subtraction arteriography in a week after operation, external drainage converted to internal drainage by the way. Results ：The serum total bilirnbin in 46 cases post-PTCD decreased significantly （P 〈 0.01 ） , and liver function was improved（ P 〈 0. 01 ）. The mean survival priod was （10.53 ± 2.35 ） months after operation. Conclusions： PTCD combined with biliary metal stent placement for treating elderly patients with malignant obstructive jaundice is an effective way. The way can improve quality of life, and is implicity, safety, good efficacy and minimal trauma, which can be the preferred approach to treat elderly patients with malignant obstructive jaundice.