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目的探讨恶性阻塞性黄疸(MOJ)合并肝叶萎缩-肥大复合征的患者行单侧胆道引流的临床疗效。方法回顾性分析本院2010年2月至2012年4月收治的32例MOJ合并肝叶萎缩-肥大复合征患者的临床资料,所有患者均接受经皮肝穿刺胆道引流术(PTCD),对萎缩肝叶胆管不予处理,仅引流代偿增生、肥大的肝叶胆管。分析治疗前后胆红素及转氨酶变化。结果所有患者行经皮穿刺胆道造影术(PTC)、内外引流术(内支架或引流管置入),技术成功率100%。共置入支架30枚。全部患者血总胆红素、转氨酶水平术前、术后统计学对比分析有显著差异。临床症状明显改善。结论对MOJ合并肝叶萎缩-肥大复合征的患者,萎缩肝叶阻塞的胆管可不予以处理,仅对代偿增生、肥大的肝叶所属的阻塞胆道行引流术,可达到功能学治愈,疗效明显,无不良反应发生。
Objective To investigate the clinical efficacy of unilateral biliary drainage in patients with malignant obstructive jaundice (MOJ) and hepatometrocyte atrophy-hypertrophy syndrome. Methods The clinical data of 32 patients with MOJ combined with hepatometropeptide atrophy and hypertrophy admitted from February 2010 to April 2012 in our hospital were retrospectively analyzed. All patients underwent percutaneous transhepatic biliary drainage (PTCD) Hepatic bile duct is not treated, only drainage compensatory proliferation, hypertrophy of liver and bile duct. Analysis of bilirubin and aminotransferase changes before and after treatment. Results All patients underwent percutaneous cholecystectomy (PTC), internal and external drainage (internal stent or drainage tube placement), the technical success rate of 100%. A total of 30 stent placement. All patients with blood total bilirubin, aminotransferase levels before and after statistical analysis showed significant differences. Clinical symptoms improved significantly. Conclusion In patients with MOJ complicated with hepatic lobe atrophy and hypertrophy syndrome, the obstruction of the obstructed hepatic bile duct may not be treated, only compensatory hyperplasia, hypertrophy of the lobulated obstruction of the bile duct may achieve functional cure, the effect is obvious No adverse reactions occurred.