恶性肿瘤胆肠吻合术后再发胆管梗阻的介入治疗.pdfVIP

· 936 · 实用医技杂志2013年9月第20卷第9期 JournalofPracticalMedicalTeehniaues，September2013，vo1．2o，No．9 恶性肿瘤胆肠吻合术后 再发胆管梗阻的介入治疗 安徽中医学院第一附属医院(230031) 闫如虎 张万高 陈大庆 王前程 徐允鹏 昊媛媛 摘【 要】 目的 探讨恶性肿瘤胆肠吻合术后再发梗阻的介入治疗方法。方法 l2例恶性肿瘤胆肠吻合术后 再发梗阻患者，l2例均行经皮肝胆管引流术(PTCD)，其中4例行胆道内支架置入术，比较介入手术前后总胆红素的 变化。结果 ·12例PTCD及胆道内支架置入术均获得成功。术后 l周总胆红素明显下降，黄疸消退满意，总有效率 100％，显效率92％。结论 PTCD及胆道内支架置入术治疗恶性肿瘤胆肠吻合术后再发梗阻具有创伤小、并发症少、 适用范围广、疗效确切优点，值得推广。 【关键词】放射学，介人性；肝管肠吻合术，肝；胆汁淤积 11【 interventtonaitreatmentforrecurrentobstructionofbinarytractafterbiuary-intestinalanastomosisinpali· entswith。mangnantq~illllOIS YANRu}·m，ZHANG~Wan-gao，CHENDa-qing．WANGQtan-cheng，xUYun-peng， U~uan-yuan．IeFirstAffdoiteaHospitaltOAnhuiTradtiionalChineseMedicineCollege。nefei230o31，China 【Ai~tractJ Objective Toinvestigatethemethodsofinterventionaltreatmentforrecurrentobstructionafterbiliary． intestinal anastomosisinpatientswithmalignanttumors．M ethods Twelvepatientswithmalignantbiliarytumorshadrec- ur-rentobstructionof biliarytractafterbiliary．intestinalanastomosis．Percutaneoustranshepaticcholangiodrainage(PI℃D) wereperformedinallcases。andpereutaneousbiliarymetalstents implantationwereperformedin4patients，thedynamic changesof TBILvaluebeofreandafterthetherapywere comparativelyanalyzed．Results Theinterventional hterapyin 12patientswas8uecessfu1．The iaundicesymptomsofallpatientswere obviouslyalleviated，comparedwiht prehterapy． Post．hterapeaticTBILvalueWas significandydecreasedandthereWas statisticdifference．Conclusion Th einterventional therapy usingpereuatneous~anshepmic cholangiodrainage combined tllimplantation ofmetallic internal stentofr recurrentobstruction of biliary tractafterbiliary．intestinalanastomosishas many advantagessuch assafe~ andsimple proeedUre，lesscomplieationsandsatisfactoryefllcacy。anditiSret：ommendable．