PTCD+金属支架治疗恶性阻塞性黄疸28例临床分析.docVIP

PTCD+金属支架治疗恶性阻塞性黄疸28例临床分析 　　摘要：目的:探究PTCD（经皮肝穿刺胆道引流）置入金属支架治疗恶性阻塞性黄疸的临床效果。方法:选取2010年1月~2012年1月我院收治的28例行PTCD置入金属支架治疗恶性阻塞性黄疸患者为研究对象，观察患者经手术治疗后的临床效果及并发症发生情况。结果:患者术后一周丙氨酸转氨酶、谷草转氨酶、谷氨酰转肽酶、总胆红素相比术前P0.05，差异具有统计学意义。28例患者手术均成功，术后出现3例引流管阻塞，2例胆道感染，1例胆道出血，给予对症治疗后好转；平均存活时间（7.5±2.8）月。结论:PTCD置入金属支架治疗恶性阻塞性黄疸操作简单，能有效缓解患者的症状，同时创伤小、效果良好，能有效延长患者的生存时间，值得临床推广使用。 　　关键词：经皮肝穿刺胆道引流；阻塞性黄疸；金属支架 　　PTCD+ metal stent in the treatment of m alignant obstructive jaundice: clinical analysis of 28 cases 　　Kong Hui 　　(Suzhou Municiple Hospital, Anhui Suzhou 234000) 　　Abstract：Objective: To explore PTCD (percutaneous transhepatic biliary drainage) clinical effect of metallic stent in the treatment of m alignant obstructive jaundice. Methods: from 2010 January ~2012 year in January in our hospital 28 cases of PTCD with metal stent in treatment of patients with m alignant obstructive jaundice as the object of study, the clinical effect and complications after treatment were observed in patients with operation. Results: after a week of patients with alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transpeptidase, total bilirubin compared with preoperative P 0.05, the difference was statistically significant. 28 cases of operation were successful, blocking drainage tube after operation in 3 cases, 2 cases of infection of biliary tract, 1 cases of biliary tract hemorrhage, symptomatic improvement after treatment; the average survival time (7.5 ± 2.8) months. Conclusion: the metal stent treatment of m alignant obstructive jaundice with PTCD has the advantages of simple operation, can effectively alleviate symptoms, at the same time, less trauma, good effect, can effectively prolong the survival time of patients, is worthy of clinical use. 　　keyword：percutaneous transhepatic biliary drainage; obstructive jaundice; metallic stent 　　恶性阻塞性黄疸是肿瘤造成肝脏内外胆道发生堵塞而引发的胆红素排出障碍，并在肝内外胆管发生淤积所出现的黄疸现象。其中最常见的是壶腹部周围癌、胰头癌、肝癌等，部分患者由于肿瘤分期或是机体自身状况，无法接受手术治疗。采用PTCD治疗能有效的缓解患者肝内胆管张力过大的现象，同时减轻黄疸症状，是恶性阻塞性黄疸患者