高级搜索

高位恶性胆道梗阻胆道双支架植入的疗效

武中林, 单保恩, 李顺宗, 李智岗, 谷铁树, 吴勇超

武中林, 单保恩, 李顺宗, 李智岗, 谷铁树, 吴勇超. 高位恶性胆道梗阻胆道双支架植入的疗效[J]. 肿瘤防治研究, 2015, 42(05): 498-501. DOI: 10.3971/j.issn.1000-8578.2015.05.017
引用本文: 武中林, 单保恩, 李顺宗, 李智岗, 谷铁树, 吴勇超. 高位恶性胆道梗阻胆道双支架植入的疗效[J]. 肿瘤防治研究, 2015, 42(05): 498-501. DOI: 10.3971/j.issn.1000-8578.2015.05.017
shu
WU Zhonglin, SHAN Baoen, LI Shunzong, LI Zhigang, GU Tieshu, WU Yongchao. Efficacy of Biliary Double Stents Implant on Malignant High Biliary Obstruction[J]. Cancer Research on Prevention and Treatment, 2015, 42(05): 498-501. DOI: 10.3971/j.issn.1000-8578.2015.05.017
Citation: WU Zhonglin, SHAN Baoen, LI Shunzong, LI Zhigang, GU Tieshu, WU Yongchao. Efficacy of Biliary Double Stents Implant on Malignant High Biliary Obstruction[J]. Cancer Research on Prevention and Treatment, 2015, 42(05): 498-501. DOI: 10.3971/j.issn.1000-8578.2015.05.017
shu

高位恶性胆道梗阻胆道双支架植入的疗效

  • 050011 石家庄，河北医科大学第四医院放射科

基金项目: 河北省强势特色学科资助项目
详细信息
    作者简介:

    武中林(1979-)，男，博士，主治医师，主要从事肿瘤介入治疗与研究

    通讯作者:

    李顺宗，E-mail: lishunzong2005@163.com

  • 中图分类号: R575；R815

Efficacy of Biliary Double Stents Implant on Malignant High Biliary Obstruction

  • Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China

摘要

    摘要
  • 摘要: 目的 分析胆道双支架植入联合胆道外引流治疗高位恶性胆道梗阻（malignant high biliary obstruction，MHBO）临床疗效及应用价值。方法 MHBO患者96例，胆道双支架植入联合胆道外引流77例、胆道单支架植入并对侧引流11例、单纯胆道外引流8例；观察术后近、远期疗效。结果 胆道双支架植入联合胆道外引流77例，成功率为80.21%。96例MHBO患者术前总胆红素、直接胆红素、谷丙转氨酶、谷草转氨酶与术后第7、14天比较，差异有统计学意义（P<0.05）；术后第21天胆道双支架植入患者总胆红素下降率（92.56%）明显高于胆道单支架植入并对侧引流和单纯胆道外引流患者（61.53%），差异有统计学意义（P<0.05）。77例胆道双支架植入患者3、6、9、12、15、18、21月生存率分别为98.70%、88.31%、76.62%、46.75%、18.18%、2.6%、1.3%。结论 胆道双支架植入联合胆道外引流治疗MHBO是一种安全有效的方法，不仅能够迅速退黄并恢复肝功能，为肿瘤的进一步治疗赢取了时间，而且能提高患者的生存质量及延长生存期。

     

    Abstract: Objective To analyze the clinical efficacy and application of biliary double stents implant combined with biliary extra-drainage in the treatment of malignant high biliary obstruction(MHBO). Methods We retrospectively analyzed 96 MHBO patients, including 77 cases of biliary double stents combined with biliary extra-drainage, 11 cases of biliary single stent implant with contralateral drainage, and 8 cases of simple biliary extra-drainage. The short- and long-term curative effects were observed after operation. Results As for 77 cases of biliary double stents combined with biliary extra-drainage, its success rate was 80.21%. As for 96 MHBO patients, total bilirubin, TBIL, direct bilirubin, DBIL, alanine transaminase, ALT, aspartate transaminase and AST before operation were significantly different from those on the 7th, 14th day after operation（P<0.05）. Total bilirubin droop rate of patients with biliary double stents implant (92.56%) was obviously higher on postoperative 21st day than those of patients with biliary single stent implant with contralateral drainage and with simple biliary extra-drainage(61.53%) (P<0.05). As for 77 patients with biliary double stents implant, the survival rates were 98.70%, 88.31%, 76.62%, 88.31%, 18.18%, 2.6%, 1.3% after 3, 6, 9, 12, 15, 18, 21 months, respectively. Conclusion Biliary double stents implant combined with biliary extradrainage is a safe and effective method to treat MHBO; it could not only quickly remove jaundice and recover liver function for further treatment of tumor, but also improve patients' quality of life and extend the lifetime.

     

    • HTML全文
    • 参考文献(13)
  • [1] Li P, Xiang XH, Cai CF, et al. Clinical efficacy of the treatment of malignant obstructive jaundice with percutaneous transhepatic cholangiography and biliary drainage (PTCD)[J]. Shi Yong Yi Xue Za Zhi, 2013, 29(11): 1762-4. [李鹏, 向贤宏, 蔡春芳, 等. 经 皮经肝胆管引流术不同术式治疗恶性梗阻性黄疸临床疗效分 析[J] 实用医学杂志, 2013, 29(11): 1762-4.]
    [2] Wu YC, Yang JW, Li GH, et al. Application of improved percutaneous transhepatic biliary drainage in the treatment of malignant hilar biliary obstruction[J]. Zhongguo Xian Dai Yi Xue Za Zhi, 2013, 23(17): 81-3. [吴英超, 杨金炜, 李冠海, 等. 改良经 皮经肝胆道引流术治疗恶性高位胆管梗阻的应用研究[J].中国 现代医学杂志, 2013, 23(17): 81-3.]
    [3] Choi J, Ryu JK, Lee SH, et al. Biliary drainage for obstructive jaundice caused by unresectable hepatocellular carcinoma the endoscopic versus percutaneous approach[J]. Hepatobiliary Pancreat Dis Int, 2012, 11(6): 636-42.
    [4] Bismuth H, Castaing D, Traynor O. Resection or palliative priority of surgery in the treatment of hilar cancer[J]. World J Surg, 1988, 12 (1): 39-47.
    [5] Li MW, Yin ZX, Han GH. The current clinical practice of percutaneous transhepatic biliary drainage for the treatment of malignant biliary obstruction[J]. Jie Ru Fang She Xue Za Zhi, 20 13, 22(10): 877-80. [李明武, 殷占新, 韩国宏. 经皮肝穿胆道 引流术治疗恶性梗阻性黄疸的临床应用现状[J]. 介入放射学杂 志, 2013, 22(10): 877-80.]
    [6] Gümü? M, Celebi F, Böyük A, et al. Dehydroepiandrosterone ameliorates hepatocellular damage in obstructive jaundice[J]. Cell Biochem Funct, 2010, 28(6): 515-20.
    [7] Yang Q, Chen ZQ, Peng Z. The study of percutaneous transhepatic insertion of biliary stent in treating malignant biliary obstruction[J]. Zhonghua Quan Ke Yi Xue, 2013, 11(1): 82-3. [杨 琦, 陈之强, 彭正. 经皮肝穿胆道支架植入术治疗恶性梗阻性黄 疸的研究[J]. 中华全科医学, 2013, 11(1): 82-3.]
    [8] Zhang XQ, Liu HJ, Wang SQ, et al. Management of malignant biliary hilar obstruction with multiple stents[J]. Zhonghua Xiao Hua Za Zhi, 2007, 27(4): 235-8. [张希全, 刘海军, 王胜强, 等. 肝 门部高位恶性胆管梗阻的多支架引流治疗[J]. 中华消化杂志, 20 07, 27(4): 235-8.]
    [9] Gao K, Dai DK, Zhai RY, et al. The interventional treatment with two stents in malignant hilar obstruction[J]. Jie Ru Fang She Xue Za Zhi, 2006, 15(12): 732-4. [高堃, 戴定可, 翟仁友, 等. 高位胆管 梗阻的双支架介入治疗[J]. 介入放射学杂志, 2006, 15(12): 732-4.]
    [10] Zou JW, Ni CF, Liu YZ, et al. Interventional therapy of hilar malignant biliary obstruction[J]. Lin Chuang Fang She Xue Za Zhi, 2011, 30(10): 1523-6. [邹建伟, 倪才方, 刘一之, 等. 不同类 型高位恶性胆道梗阻的介入治疗[J]. 临床放射学杂志, 2011, 30 (10): 1523-6.]
    [11] Xie QG, Wang WG, Hua YY, et al. Percutaneous transhepatic cholangial drainage combined with stenting therapy for malignant obstruction jaundice[J]. Zhongguo Xian Dai Yi Yao Za Zhi, 2013, 15 (12): 18-21. [谢其根, 王卫国, 华燕艳, 等. 经皮肝穿刺胆道引 流联合支架植入治疗恶性梗阻性黄疸疗效观察[J]. 中国现代医 药杂志, 2013, 15(12): 18-21.]
    [12] Fan HW, Liu HC, Li ZK, et al. Analysis of clinical curative effect on 137 malignant obstructive jaundice patients with the treatment of metal biliary stent placement by PTCD[J]. Gan Dan Wai Ke Za Zhi, 2013, 21(2): 94-7. [范恒伟, 刘会春, 李宗狂, 等. 经PTCD途 径胆道金属支架置入术治疗恶性梗阻性黄疸137例临床疗效分 析[J] 肝胆外科杂志, 2013, 21(2): 94-7.]
    [13] Xie ZG, Zhang XQ, Li FD, et al. Biliary stenting technique in 5 years: a follow-up report of 213 cases[J]. Zhonghua Gan Dan Wai Ke Za Zhi,2002,8(10):595-7.[谢宗贵, 张希全, 李凡东, 等.胆道 支架技术5年回顾(213例随访报告) [J]. 中华肝胆外科杂志, 20 02, 8(10): 595-7.]
    • 相关文章
    • 施引文献
    • 资源附件(0)
计量
  • 文章访问数:  1333
  • HTML全文浏览量:  325
  • PDF下载量:  77883
  • 被引次数: 0
出版历程
  • 收稿日期:  2014-05-14
  • 修回日期:  2014-06-21
  • 刊出日期:  2015-05-24

目录

摘要
HTML全文
    参考文献(13)
    相关文章
    施引文献
    资源附件(0)

    /

    返回文章
    返回

    下载中心

    友情链接

    联系我们

    地址：武汉市洪山区卓刀泉南路116号（430079）

    电话：027－87670126

    Email：zlfzyjzz@vip.163.com

    This work is licensed under a Creative Commons Attribution 3.0 License.

    邮件订阅 RSS
    总访问量： 今日访问：

    版权所有 © 《肿瘤防治研究》编辑部 鄂公网安备 42011102005013号 鄂ICP备2022015867号

    本系统由北京仁和汇智信息技术有限公司开发  百度统计

    x 关闭 永久关闭