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目的:研究经皮胆道金属内支架植入术姑息性治疗恶性梗阻性黄疸的临床价值。材料和方法:53例恶性梗阻性黄疸患者在经皮胆道造影后进行了经皮胆道金属内支架植入术,共植入内支架58枚。结果:全组内支架植人的成功率98.1%(52/53);52例治疗前后血清总胆红素相差值为182±67μmol/L,P<0.005,其中总胆红素恢复正常或接近正常者39例;下降百分比750%者7例;25%～50%者3例;<5%者3例。全组30天病死率3.8%(2/53),早期并发症15.1%(8/53)。在平均随访6.9个月内,再阻塞率13.8%(4/29),4例均进行了再次介入治疗。结论:经皮金属内支架胆道植入术是姑息性治疗手术不能切除的恶性梗阻性黄疸有效方法。
Objective: To study the clinical value of percutaneous biliary metallic stent implantation for palliative treatment of malignant obstructive jaundice. Materials and Methods: Fifty-three patients with malignant obstructive jaundice underwent percutaneous biliary metallic stent implantation after percutaneous cholangiography. A total of 58 stents were implanted. Results: The success rate of stent implantation in the whole group was 98.1% (52/53); the difference between total serum bilirubin levels before and after treatment was 182±67 μmol/L, P<0.005, and total bilirubin returned to normal or near 39 cases were normal; 7 cases were decreased by 750%; 3 cases were 25% to 50%; 3 cases were <5%. The 30-day mortality rate of the whole group was 3.8% (2/53), and the early complication was 15.1% (8/53). During a mean follow-up of 6.9 months, the rate of reocclusion was 13.8% (4/29). All 4 patients were reintervented. CONCLUSION: Percutaneous metal stent placement is an effective method for palliative treatment of malignant obstructive jaundice that cannot be removed by surgery.