CAJ | 학술논문

目的：探讨介入方式治疗恶性梗阻性黄疸（malignant obstructive jaundice，MOJ）的临床效果及价值。方法对76例MOJ患者行经皮肝穿刺胆管内支架置入术（percutaneous transhepatic insertion of biliary stent，PTIBS），术后35例患者联合介入方法抗肿瘤综合治疗。结果76例MOJ患者均成功置入金属胆道支架，共置入金属胆道支架102枚。根据患者不同的梗阻类型置入支架放置部位不同，30例肝门部置入金属胆道支架共56枚（26例置入双支架），34例胆总管部置入支架共34枚，12例壶腹部置入支架12枚。术后2周复查血清总胆红素（TBIL）、直接胆红素（DBIL）及谷丙转氨酶（ALT），进行独立样本t检验，P值均<0.05。随访74例患者（失访2例），PTIBS术后是否行介入抗肿瘤治疗患者的生存时间及支架的通畅时间进行卡方检验，P值均<0.05。结论 PTIBS技术成功率高，退黄效果明显。PTIBS结合介入方式进行抗肿瘤治疗，可延长患者的生存时间及支架的通畅时间。
목적：탐토개입방식치료악성경조성황달（malignant obstructive jaundice，MOJ）적림상효과급개치。방법대76례MOJ환자행경피간천자담관내지가치입술（percutaneous transhepatic insertion of biliary stent，PTIBS），술후35례환자연합개입방법항종류종합치료。결과76례MOJ환자균성공치입금속담도지가，공치입금속담도지가102매。근거환자불동적경조류형치입지가방치부위불동，30례간문부치입금속담도지가공56매（26례치입쌍지가），34례담총관부치입지가공34매，12례호복부치입지가12매。술후2주복사혈청총담홍소（TBIL）、직접담홍소（DBIL）급곡병전안매（ALT），진행독립양본t검험，P치균<0.05。수방74례환자（실방2례），PTIBS술후시부행개입항종류치료환자적생존시간급지가적통창시간진행잡방검험，P치균<0.05。결론 PTIBS기술성공솔고，퇴황효과명현。PTIBS결합개입방식진행항종류치료，가연장환자적생존시간급지가적통창시간。
Objective To investigate the treatment of malignant obstructive jaundice(MOJ) clinical results and value through intervention. Methods The curative effect of 76 patients with malignant biliary obstruction who accepted the interventional treatment were retrospectively analyzed. All patients were treated through percutaneous transhepatic cholangial drainage and percutaneous transhepatic insertion of biliary stent,35cases of patients with combined intervention approaches antitumor dual interventional therapy. Results 76 patients were successfully implanted biliary metal stents,102 metal stents were implanted. The stents were implanted in different parts according to the different types of obstruction,56 stents were implanted in the hepatic portal of 30 patients(26 patients were implanted in double stents),34 stents were implanted in common bile duct of 51 patients,12 stents were implanted in ampullary of patients. After PTIBS drainage in patients with serum total bilirubin(TBIL),direct bilirubin(DBIL)and alanine aminotransferase(ALT)as independent samples carried t test,p values were less than 0.05. 74 patients(2 patients were lost)were followed up to check whether intervention treatment was applied, the survival and the stents patency. Chi-square test was carried and the p values were less than 0.05. Conclusion PTIBS has high success rate ,the treatment effect of MOJ is obvious. PTIBS combining intervention prolongs the time of patients survival and improves stents patency.