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目的 :探讨晚期胰腺癌和 /或合并阻塞性黄疸的介入治疗方法 ,对动脉灌注药物及经皮肝穿刺植入胆道支架的临床效果给予讨论。方法 :采用Seldinger技术经股动脉插管胰腺供血动脉内灌注化疗药物 ,经皮肝穿刺进行外引流或植入胆道支架进行内引流解除黄疸。结果 :12例病人疼痛症状明显改善 ,有 3例病人肿瘤体积有所缩小 ,行PTCD病人黄疸完全解除。结论 :动脉灌注化疗对缓解肿瘤生长速度和减少疼痛是一种可选择的有效方法 ,但对减少肿瘤体积、改善黄疸疗效有限。经皮肝穿刺胆汁外引流和植入胆道支架内引流可有效解除黄疸 ,改善症状 ,延长病人生存期。
Objective: To investigate the interventional treatment of advanced pancreatic cancer and / or obstructive jaundice and to discuss the clinical effect of intra-arterial infusion and percutaneous transhepatic implantation of biliary stents. Methods: The Seldinger technique was used to perfuse chemotherapeutic drugs through the femoral artery in the pancreas feeding artery. Percutaneous transhepatic puncture was used for external drainage or implantation of biliary stents for internal drainage to relieve jaundice. Results: The pain symptoms of 12 patients were significantly improved. The tumor volume of 3 patients was reduced, and the patients with PTCD were completely relieved of jaundice. Conclusion: Arterial infusion chemotherapy is an effective and effective method to relieve tumor growth and reduce pain, but it has limited curative effect on reducing tumor volume and improving jaundice. Percutaneous transhepatic biliary drainage and implantation of biliary stent drainage can effectively relieve jaundice, improve symptoms and prolong survival of patients.