支架置入治疗不同梗阻部位恶性梗阻性黄疸疗效评价.docVIP

支架置入治疗不同梗阻部位恶性梗阻性黄疸疗效评价 　　【摘要】 目的：探讨经皮经肝胆道支架置入术对不同梗阻部位恶性梗阻性黄疸的近期疗效。方法：回顾2010年9月-2014年9月山西医科大学第二医院介入科在DSA引导下行胆道支架置入治疗的72例恶性梗阻性黄疸患者。根据梗阻部位不同，将患者分为高位梗阻组（30例）和低位梗阻组（42例），比较手术前后两组的总胆红素变化情况。结果：72例患者全部穿刺成功，穿刺成功率100%。两组术前术后总胆红素变化比较差异均有统计学意义（P0.05）；低位梗阻组术后胆红素变化与高位梗阻组比较差异有统计学意义（P0.001）。结论：胆道支架置入术是姑息性治疗恶性梗阻性黄疸的有效方法，低位恶性梗阻性黄疸胆道支架置入术后疗效较高位更满意。 　　【关键词】 恶性梗阻性黄疸； 高低位梗阻； 胆道支架； 疗效 　　【Abstract】 Objective：To study the short-term effects of percutaneous transhepatic cholangio-drainage combining with biliary stent in different obstruction areas of malignant obstructive jaundice. Method：72 patients with malignant obstructive jaundice who accepted DSA-guided biliary stent at the department of interventional radiology in the Second Hospital of Shanxi Medical University were selected and reviewed from September 2010 to September 2014.According to the different obstruction area，they were divided into high obstruction group for 30 cases and low obstruction group for 42 cases， before and after operation， the situation of total bilirubin changes in two groups were compared.Result：All the patients successfully punctured and the success rate of puncture was 100%. Before and after operation，the changes of total bilirubin of two groups had statistically significant（P0.05）.The decrease in bilirubin of low obstruction group was more significantly than that of high obstruction group，the difference was statistically significant（P0.05）.Conclusion：Biliary stenting is an effective method for malignant obstructive jaundice of palliative treatment.Compared with high malignant obstructive jaundice， the short-term effect on low malignant obstructive jaundice is more satisfied. 　　【Key words】 Malignant obstructive； High and low obstruction； Biliary stent； Effect 　　First-author’s address：The Second Hospital of Shanxi Medical University，Taiyuan 030001，China 　　doi：10.3969/j.issn.1674-4985.2015.28.041 　　恶性梗阻性黄疸是由各种恶性肿瘤引起的不同部位的胆管狭窄或闭塞，常见原因有胆管癌、胆囊癌、胰腺癌、壶腹癌和肝原发、转移癌、胃肠道腺癌转移等。目前，胆道内支架置入术已成为恶性梗阻性黄疸姑息性治疗的有效方法，能够在短期