经皮肝穿胆道引流及支架置入治疗恶性阻塞性黄疸的临床疗效

The Clinical Efficacy of Percutaneous Transhepatic Biliary Drainage and Stent Placement in the Treatment Ofmalignant Obstructive Jaundice

目的探讨经皮肝穿胆道引流及支架置入术治疗恶性阻塞性黄疸的临床效果。方法对该院51例恶性阻塞性黄疸患者,在数字减影血管造影机(DSA)引导下,经皮肝穿刺胆道引流及支架置入术,并对比手术前和手术后肝功及黄疸的改善情况。结果 51例患者,31例放置支架(37枚),19例单纯外引流。手术成功30例(98%),1例穿刺失败。1例气胸,3例胆汁性腹膜炎,3例胆道出血,并发症发生率13.7%。术后的血清总胆红素有明显降低,手术前后差异具有统计学意义(P<0.05)。结论 经皮肝穿胆道引流及支架置入术,在恶性阻塞性黄疸的治疗过程中,疗效可靠,创伤小,症状缓解速度快,且并发症少,能有效提升患者的生存质量。

Objective To observe the clinical effect of percutaneous transhepatic biliary drainage and stent implantation in the treatment of malignant obstructive jaundice. Methods in our hospital, 31 cases of malignant obstructive jaundice patients, in the digital subtraction angiography （DSA） guided, percutaneous transhepatic biliary drainage and stent implantation, and to improve the situation of liver and jaundice contrast before and after operation. Results among the 31 cases, 19 cases of stent placement （23）, 11 cases of simple external drainage.The operation was successful in 30 cases （96.8%）, 1 cases failed. 1 cases of pneumothorax, 2 cases of bileperitonitis, 2 cases of biliary tract bleeding, complication rate 16.7%. Serum total bilirubin after operation were signifi-cantly decreased. The difference has statistical significance before and after operation （P 〈 0.05）. Conclusion percutaneous tran-shepatic biliary drainage and stenting, surgical treatment is safe in the process ofmalignant obstructive jaundice, and and the cura-tive effect is reliable.