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目的:探讨经皮经肝穿刺胆管引流(PTCD)及胆道支架置入术,治疗恶性梗阻性黄疸并发症发生的原因和处理措施。方法:恶性梗阻性黄疸261例,其中166例行PTCD,91例行胆道支架置入术,4例未完成手术。分析术后2月内并发症发生情况。结果:发生并发症68例,发生率26.05%。胆道感染21例,胆道出血13例,引流管脱出、阻塞11例,胆瘘7例,胆心反射5例,急性胰腺炎5例,支架再狭窄3例,胆汁性胸膜炎1例,肝脓肿1例,死亡1例。除死亡病例外,其余患者经过积极处理,病情好转平稳。介入治疗后黄疸明显减轻。结论:PTCD及胆道内支架置入术是治疗恶性梗阻性黄疸的有效方法,严重并发症发生率低,正确的手术操作及合理的围手术期处理对降低并发生的发生极为重要。
Objective: To investigate the causes and management of percutaneous transhepatic biliary drainage (PTCD) and biliary stenting in the treatment of complications of malignant obstructive jaundice. Methods: 261 cases of malignant obstructive jaundice, of which 166 cases were treated with PTCD, 91 cases were treated with biliary stenting, and 4 cases were incomplete. Analysis of complications within 2 months after the occurrence. Results: Complications occurred in 68 cases, the incidence rate of 26.05%. 21 cases of biliary tract infection, 13 cases of biliary tract bleeding, drainage tube prolapse, obstruction in 11 cases, 7 cases of biliary fistula, biliary heart reflex in 5 cases, 5 cases of acute pancreatitis, stent restenosis in 3 cases, bile pleurisy in 1 case, liver abscess 1 Case, 1 patient died. In addition to deaths, the remaining patients after active treatment, the disease improved smoothly. Jaundice significantly reduced after interventional therapy. Conclusion: PTCD and biliary stenting are effective methods for the treatment of malignant obstructive jaundice. The incidence of serious complications is low. Correct operation and reasonable perioperative management are very important for the reduction and occurrence of malignant obstructive jaundice.