目的:探讨采用经皮肝穿刺胆道内射频消融联合胆道支架治疗恶性胆道梗阻患者的效果。方法:回顾性分析2016年1月至2019年1月河南科技大学附属三门峡市中心医院肝胆外科收治的150例恶性胆道梗阻患者的临床资料，男101例，女49例，年龄(59.38±5.95)岁，年龄范围为23～78岁。根据手术方式不同分为胆道支架组(n n＝60)与联合治疗组(n n＝90)。比较两组患者的肝功能指标[总胆红素、直接胆红素(DBIL)、谷氨酸氨基转移酶(ALT)及γ-谷氨酰转肽酶(γ-GT)]、支架通畅率及并发症发生率。n 结果:胆道支架组患者术后的总胆红素[(99.12±20.05)μmol/L]、DBIL[(75.17±15.08)μmol/L]、ALT水平[(205.20±42.11)U/L]低于术前[(128.93±25.23)μmol/L、(105.24±21.47)μmol/L、(330.58±83.56)U/L]，γ-GT水平[(33.83±3.03)U/L]高于术前[(30.54±2.02)U/L]，差异有统计学意义(n P<0.05)；联合治疗组患者术后的总胆红素[(80.11±15.06)μmol/L]、DBIL[(58.13±12.09)μmol/L]、ALT水平[(135.13±30.08)U/L]低于术前[(127.91±24.25)μmol/L、(104.93±20.27)μmol/L、(331.25±85.56)U/L]，γ-GT水平[(37.26±3.09)U/L]高于术前[(30.85±2.12)U/L]，差异有统计学意义(n P<0.05)。联合治疗组患者的总胆红素、DBIL、ALT水平低于胆道支架组，γ-GT水平高于胆道支架组，差异有统计学意义(n P0.05)；联合治疗组患者术后9个月时支架通畅率[92.2%(83/90)]高于胆道支架组[71.7%(43/60)]，差异有统计学意义(n P0.05)。n 结论:恶性胆道梗阻患者采用经皮肝穿刺胆道内射频消融联合胆道支架治疗的效果较好，可有效改善肝功能，提高后期支架通畅率，且具有一定的安全性。“,”Objective:To investigate the effect of using percutaneous transhepatic biliary radiofrequency ablation combined with biliary stent in the treatment of patients with malignant biliary obstruction.Methods:A retrospective study was performed on 150 cases of patients with malignant biliary obstruction who were admitted to the department of Hepatobiliary Surgery, Sanmenxia Central Hospital Affiliated to Henan Science and Technology University from January 2016 to January 2019.There were 101 males, 49 females, aged(59.38±5.95)years old, aging from 23 to 78 years old.According to different surgical methods, the patients were divided into the biliary stent group(n n=60)and combined treatment group(n n=90). The liver function indexes[total bilirubin, direct bilirubin(DBIL), alanine transaminase(ALT)and gamma glutamyl transpeptidase(γ-GT)], stent patency rate and complication rate were compared between the two groups.n Results:In the biliary stent group, the postoperative bilirubin[(99.12±20.05)μmol/L], DBIL[(75.17±15.08)μmol/L], ALT level[(205.20±42.11)U/L] were lower than those before surgery[(128.93±25.23)μmol/L, (105.24±21.47)μmol/L, (330.58±83.56)U/L], and γ-GT level[(33.83±3.03)U/L] were higher than those before surgery[(30.54±2.02)U/L], and the difference was statistically significant(n P<0.05). In the combined treatment group, the postoperative bilirubin[(80.11±15.06)μmol/L], DBIL[(58.13±12.09)μmol/L], ALT[(135.13±30.08)U/L] were lower than those before surgery[(127.91±24.25)μmol/L, (104.93±20.27)μmol/L, (331.25±85.56)U/L], and γ-GT levels[(37.26±3.09)U/L] were higher than those before surgery[(30.85±2.12)U/L], and the difference was statistically significant(n P<0.05). The levels of total bilirubin, DBIL and ALT in the combined treatment group were lower than those in the biliary stent group, and the levels of γ-GT were higher than those in the biliary stent group(n P0.05). At 9 months after operation, the stent patency rate in the combined treatment group was[92.2%(83/90)], higher than that in the biliary stent group, which was[71.7%(43/60)], and the difference was statistically significant(n P0.05).n Conclusion:The treatment of patients with malignant biliary obstruction by percutaneous transhepatic biliary radiofrequency ablation combined with biliary stent has a better effect, which can effectively improve liver function, improve the patency rate of the stent in the later period, with certain safety.