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目的:评价伴肝脏转移的胰头癌患者内镜胆道内支架引流治疗的临床意义.方法:门诊就诊和转院的胰头癌伴有肝脏转移患者,如具有严重的梗阻性黄疸则符合内镜逆行胆胰管造影救治指征,然后按照知情同意的原则进入治疗研究计划.均应用内镜胆道内支架引流技术,包括金属内支架和塑料支架,治疗出院后随访观察至患者死亡.结果:16例患者进入治疗研究,其中伴有腹膜后淋巴结转移5例.均采用内镜胆道支架引流术,其中应用胆道金属支架12例,胆道塑料支架4例,胰管内支架6例.治疗后1wk时梗阻性黄疸缓解率100%,精神状况明显好转75.0%(12/16),食欲改善25.0%(4/16),睡眠改善37.5%(6/16).治疗后的患者最短生存期为9d,最长生存期为134d,平均81.4d±50.2d.随访数据表明治疗有意义的97%,治疗效果满意的11例.结论:对于伴有肝脏转移的胰头癌患者,内镜胆道内支架引流技术不仅能解除梗阻性黄疸而且可以一定程度的改善生存质量,具有一定的临床应用价值.
Objective: To evaluate the clinical significance of endoscopic biliary stent drainage in patients with metastatic pancreatic head cancer with liver metastasis.Methods: Outpatients were referred to the hospital for treatment of pancreaticoduodenectasis accompanied by liver metastases, such as patients with severe obstructive jaundice in line with endoscopic retrograde Cholangiopancreatography rescue treatment indications, and then follow the principle of informed consent to enter the treatment of research projects are applied endoscopic biliary stent drainage techniques, including metal stent and plastic stent, the treatment of patients were followed up after discharge observed.Results: 16 cases The patients entered the treatment study, which was associated with retroperitoneal lymph node metastasis in 5 cases were treated with endoscopic biliary stent drainage, including the application of biliary metal stent in 12 cases, 4 cases of biliary plastic stent, pancreatic duct stent in 6. 1wk after treatment obstruction Jaundice remission rate was 100%, mental status was significantly improved 75.0% (12/16), appetite improved 25.0% (4/16), sleep improvement 37.5% (6/16) .The treatment of patients with shortest survival time of 9d, the longest The survival time was 134 days, with an average of 81.4 days ± 50.2 days. The follow-up data showed that 97% of the patients were treated with satisfactory results and 11 were satisfactory. CONCLUSIONS: Endoscopic biliary stent drainage is not only effective for patients with metastatic pancreatic cancer, Can lift the obstruction Jaundice but also a certain degree of improvement in quality of life, has some clinical value.