论文部分内容阅读
目的 观察经皮肝穿胆道支架置入术 ,在姑息治疗恶性梗阻性黄疸的临床疗效。方法 对恶性梗阻黄疸的 74例胆道支架 (包括 42例金属支架与 3 2例内涵管 )内引流术后临床资料作回顾分析。结果 术后对降低胆红素和改善临床症状均有明显疗效 ,胆红素以术后 1周时间下降最明显 ,术后 3周趋向正常。胆道支架以选择上段胆管梗阻为多 (占 5 2 .7% )。术后早期并发症较少 ;晚期并发症主要为支架阻塞。金属支架半年阻塞率为 19% ,平均开通时间为 2 14d ,内涵管半年阻塞率为 2 5 % ,平均开通时间为12 2d。结论 胆道支架能有效解除胆道梗阻 ,降低胆红素 ,尤其对高位胆道梗阻有较大优势 ;由于其微创性 ,适合于年老体弱者 ,估计生存期较短 (<6个月 ) ,宜选择支架引流 ,如选择金属支架 ;经济条件不许可者 ,可选用内涵管。
Objective To observe the clinical effect of percutaneous transhepatic biliary stenting in palliative treatment of malignant obstructive jaundice. Methods The clinical data of 74 cases of malignant obstructive jaundice after biliary drainage (including 42 cases of metal stent and 32 cases of endoprosthesis) were retrospectively analyzed. Results The postoperative effects of reducing bilirubin and improving clinical symptoms were obvious. The bilirubin decreased most obviously after 1 week and normal after 3 weeks. Biliary stents to select the upper bile duct obstruction (52.7%). Less postoperative complications; late complications mainly for stent blockage. The half-year block rate of metal stent was 19%, the average open time was 2 14 days, the half-year obstruction rate of internal medicine tube was 25% and the average open time was 12 2 days. Conclusion Biliary stents can effectively relieve biliary obstruction and reduce bilirubin, especially for high biliary obstruction. Due to its minimal invasiveness, it is suitable for the aged and infirm, with short survival (<6 months) Select the stent drainage, such as the choice of metal stent; economic conditions are not allowed, the optional use of culvert.