CAJ | 학술논문

目的探讨不能手术切除的胰头癌患者行经皮胆道支架置入与姑息性胆肠内引流术的疗效差异.方法回顾分析我院2005年12月至2011年12月不能手术切除且得到随访的72例胰头癌患者的临床资料,比较经皮经肝胆管引流(PTCD)途径胆道金属支架置入与姑息性胆肠Roux-enY内引流两种方法的疗效差异.结果 35例患者采用经PTCD途径胆道金属支架置入术.其中男性21例,女性14例,年龄38 ～ 90岁,平均年龄(70.17±12.39)岁.术后平均生存时间为(9.30±7.38)个月；姑息性胆肠Roux-en-Y内引流术37例.其中男性26例,女性11例,年龄29～78岁,平均年龄(62.73±12.61)岁,术后平均生存时间为(8.80±6.95)个月.支架组与手术组相比在患者年龄、ALT、TBil及ALB更差的情况下,可同样有效解除患者胆道梗阻、改善肝功能,且术后生存时间无明显差异(P＞0.05).结论 PTCD途径胆道金属支架置入可解除胆道梗阻、改善全身状况.其与姑息性胆肠Roux-en-Y内引流相比具有简便、安全、创伤小、可重复以及可为后续治疗创造条件等优点,尤其适用于高龄、身体状况差、失去手术切除机会的胰头癌患者.
목적 탐토불능수술절제적이두암환자행경피담도지가치입여고식성담장내인류술적료효차이.방법 회고분석아원2005년12월지2011년12월불능수술절제차득도수방적72례이두암환자적림상자료,비교경피경간담관인류(PTCD)도경담도금속지가치입여고식성담장Roux-enY내인류량충방법적료효차이.결과 35례환자채용경PTCD도경담도금속지가치입술.기중남성21례,녀성14례,년령38 ～ 90세,평균년령(70.17±12.39)세.술후평균생존시간위(9.30±7.38)개월；고식성담장Roux-en-Y내인류술37례.기중남성26례,녀성11례,년령29～78세,평균년령(62.73±12.61)세,술후평균생존시간위(8.80±6.95)개월.지가조여수술조상비재환자년령、ALT、TBil급ALB경차적정황하,가동양유효해제환자담도경조、개선간공능,차술후생존시간무명현차이(P＞0.05).결론 PTCD도경담도금속지가치입가해제담도경조、개선전신상황.기여고식성담장Roux-en-Y내인류상비구유간편、안전、창상소、가중복이급가위후속치료창조조건등우점,우기괄용우고령、신체상황차、실거수술절제궤회적이두암환자.
Objective To compare percutaneous metallic biliary stenting with biliary-enteric bypass in the palliative treatment of unresectable pancreatic cancer.Methods A retrospective study was conducted on all patients with unresectable pancreatic cancer with malignant obstructive jaundice treated in our hospital from December 2005 to December 2011.Results 35 patients received percutaneous metallic biliary stenting.There were 21 males and 14 females,aged 38 to 90 years,with a mean of 70.17 ± 12.39 years.The mean survival time was 9.30 ± 7.38 months.37 patients received palliative biliary-enteric Roux-en-Y internal drainage.There were 26 males and 11 females,aged 29 to 78 years,with a mean of 62.73 ± 12.61 years.The mean survival time was 8.80 ± 6.95 months.The stenting group when compared with the surgical group were more severe in age,ALT、TBIL and ALB.However,stenting was equally effective in relieving biliary obstruction and improving liver function.There was no significant difference in survival between the 2 groups (P ＞ 0.05).Conclusion For patients who are not candidates for curative resectional surgery to treat pancreatic cancer,percutaneous metallic biliary stenting is an effective treatment to relieve biliary obstruction and to improve the general condition of the patient.It is a simple,safe,minimally invasive and repeatable treatment and it should be the first choice treatment over a palliative biliary-enteric bypass operation.