影响梗阻性黄疸介入治疗效果的相关因素分析

Correlative Factors Influencing the Effect of Interventional Therapy for Malignant Obstructive Jaundice

目的:分析影响梗阻性黄疸介入治疗效果的相关因素,探讨对策。方法:41例恶性梗阻性黄疸患者,男26例、女15例;年龄33～91岁。胃癌肝门淋巴结转移8例、肝癌21例、胆管癌6例、胰头癌6例。经皮经肝穿刺胆道造影,球囊导管扩张,置入金属胆道内支架或行PTCD引流。对术前后的肝、肾功能及并发症情况进行统计分析。结果:支架置入成功率92.68％,显效20例,有效9例,无效12例,有效率70.73％,术后胆红素下降(105.47±100.96)μmol/L。11例出现并发症,30d内死亡3例。疗效相关因素有:肿瘤类别、肝功能级别、肝硬化情况、白蛋白与球蛋白数值、梗阻部位与性质及并发症。结论:PTCD及PTIBS治疗梗阻性黄疸效果显著。注意术前全身状态的改善,提高操作技巧,及时发现和控制胆系感染,减少并发症,加强术后综合治疗,局部治疗与全身治疗并重,有望使疗效进一步提高。

Objective: To analyze correlative factors influencing the effect of interventional therapy for malignant obstructive jaundice and study the corresponding therapy measure. Methods: There were 41 cases of malignant obstructive jaundice, male 26, female 15: 33-91years old (mean 58.27112.94). The biliary obstruction was caused by hepatoma 21 cases: liver portal lymph node metastasis with stomach cancer 8 cases, biliary carcinoma 6 and pancreatic cancer 6 cases . First, a percutaneous transhepatic cholangiography(PTC)was done, then bile duct stricture was dilated with balloon catheter, a biliary metallic stent was inserted(PTIBS) or biliary drainage(PTCD) was performed. The changes of data before and after operation and the correlation with therapy effectwere steadied. The data included liver and kidney function: with cirrhosis or not: the obstructive position and nature: tumor type and complication, et al. Results: There were 38 cases inserted 40 biliary stents successfully(92. 68%). There were 20 cases completely effect, 9 cases partial effect, 11 no effect: the effectual rate was 70.73%: the mean serum bilirubin decreased 107.47?