经皮肝穿刺胆道引流术后腔内射频消融联合支架植入治疗恶性梗阻性黄疸.docVIP

经皮肝穿刺胆道引流术后腔内射频消融联合支架植入治疗恶性梗阻性黄疸 【摘要】 目的 探讨经皮肝穿刺胆道引流（PTCD）后联合应用腔内射频消融（RFA）及支架植入治疗恶性梗阻性黄疸的临床应用价值。方法 对7例恶性梗阻性黄疸患者，先行经皮肝穿刺胆道引流术后再行胆道腔内RFA联合支架植入术，观察并发症、黄疸消退情况、术后6月内胆道支架通畅情况及患者生存期。结果 7例患者均成功进行手术治疗，术后血清总胆红素及直接胆红素明显下降。均无胆道穿孔、出血等严重并发症，术后6月胆道支架通畅率为71%（5/7）。结论 经皮肝穿刺胆道引流术后腔内射频消融联合支架植入治疗恶性梗阻性黄疸是一种安全可行的新的手术方式。相对于传统的介入治疗方式，可进一步阻止肿瘤的局部增长, 从而延长内支架的通畅期和患者的存活期，改善患者生存质量。 【关键词】 胆道腔内射频消融 恶性梗阻性黄疸 支架 PTCD Malignant obstructive jaundice treated with Percutaneous Transhepatic Choleductus Drainage first and then endoscopic Radiofrequency Ablation combined with stent implantation 【Abstract】 Objective the clinical application value of radiofrequency ablation combined with biliary stenting to cure malignant obstructive jaundice after liver puncture percutaneous biliary drainage . Methods Percutaneous endobiliary radiofrequency ablation combined with biliary stenting was carried out in 7 patients with malignant obstructive jaundice after they received percutaneous transhepatic biliary drainage. The complications, jaundice subsiding,survival time, and stent patency at six months after the treatment were recorded. Results The treatment was successful in all 7 cases.After the treatment the serum total bilirubin and direct bilirubin level decreased obviously. No serious complications such as bile duct bleeding,perforation of bile duct occurred. The stent remained unobstructed rate was 57% during the follow-up period of six months. Conclusion Percutaneous endobiliary radiofrequency ablation combined with biliary stenting is clinically safe and feasible new way of treatment for malignant obstructive jaundice. Compared with the traditional way of interventional therapy, radiofrequency can arrest the local tumor growth to promote the patency of the stent as well as the postoperative survival of the patients and improve the patients quality of life. . 【Key words】 radiofrequency ablation；malignant obstructive jaundice；stent；percutaneous transhepatic cholangial drainage 3月。对于预期寿命大于3个月的恶性梗阻性黄疸患者标准治疗