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目的 :探讨经皮肝穿刺胆道内支架置入术结合动脉化疗栓塞治疗恶性胆道梗阻的临床疗效。方法 :12例恶性胆道梗阻病人采用经皮肝穿刺胆道内支架置入术 ,2周后行供血动脉灌注化疗和 /或化疗栓塞 ,每月一次。结果 :12例病人共放置国产网状支架 14枚。 11例病人血清胆红素水平由术前 5 34± 12 0 μmol/L降至术后的 45± 2 3μmol/L。半年以上生存率 83.3% ,一年以上生存率 5 0 % ,2例病人 4个月后因胆管再次梗阻第二次置放支架。 12例病人共行动脉化疗栓塞 35次 ,显示了明确疗效。结论 :经皮肝穿刺胆道内支架置入术结合动脉化疗栓塞是治疗恶性胆道梗阻安全、有效的方法。
Objective : To explore the clinical efficacy of percutaneous transhepatic biliary stenting combined with arterial chemoembolization for malignant biliary obstruction. Methods : Twelve cases of malignant biliary obstruction were treated with percutaneous transhepatic biliary stenting. Two weeks later, arterial infusion chemotherapy and/or chemoembolization were performed once a month. Results: A total of 14 domestic mesh stents were placed in 12 patients. The serum bilirubin level in 11 patients decreased from 5 34± 12 0 μmol/L preoperatively to 45±23 μmol/L after surgery. The survival rate was 83.3% for more than half a year, and the survival rate was 50% or more for more than one year. Two patients placed the stent for the second time after four months because of biliary obstruction. Twelve patients underwent arterial chemoembolization for 35 times, showing a clear effect. Conclusion: Percutaneous transhepatic biliary stenting combined with arterial chemoembolization is a safe and effective method for the treatment of malignant biliary obstruction.