【摘要】 目的 探讨恶性梗阻性黄疸介入治疗的方法及术后处理。方法 26例恶性梗阻性黄疸患者接受介入治疗,男21例,女5例。年龄35～80a,平均64a。其中,胰头癌11例,胆管癌9例,肝癌1例,转移癌3例,胆囊癌2例。放置支架及内外引流管21例,单纯放置外引流管2例,单纯放置内外引流管3例。结果 26例患者引流管引流通畅,21例支架扩张良好,无移位。术后1wk血清总胆红素由术前427.6±113.4μmol/L下降到178.8±65.3μmol/L,24例黄疸明显消退,1例消退不明显,1例胆道出血死亡。随访1mo胆道感染死亡1例,全身衰竭死亡2例,其余患者生存良好。结论 恶性梗阻性黄疸介入治疗创伤小,疗效确切,能提高患者生存质量,延长寿命。更多还原

【Abstract】 Objective To explore the techniques of interventional therapy for malignant biliary obstruction and the teatment after operation . Methods Percutaneous stent implantation and internal - external catheter drainage were adopted in 26 patients (21 males and 5 females ) with malignant biliary obstruction, the age ranged from 35 to 80 years and the mean age was 64 years . Biliary obstruction was caused by panccreatic carcinoma (n=11 ), biliary duct cancer ( n = 9), hepatic carcinoma (n=1 ), metastases (n = 3 ) or carcinoma of gallbladder (n = 2) .Twenty-one patients received biliary stent implantation and internal -external catheter drainage , two patients were simply treated with external catheter drainage , three patients were simply treated with internal - external catheter drainage . Results All catheter drainage were efficient , 21 stents obtained satisfactory internal draining function , no stent replacement in those cases . The serum total bilirubin decreased from 427. 6± 113. 4μmol / L before the procedure to 178. 8 ± 65. 3μmol / L one week after the operation . Subsidence of jaundice was satisfactory in 19 cases , and disappeared unsatisfactory in 2 cases . One case died from the bleeding of bile - ducts at first week after operation . Other cases were followed up for one month , one case died from infection of bile - ducts , and two cases died from failure of more organ among them. Conclusions Percutaneous transhepatic biliary drainage and stent implantation are simple, safe and effective for the malignant biliary obstruction .更多还原