PTBD及PTIBS治疗胆道恶性梗阻的临床研究

摘要

Objective:To evaluate the curative effects and complications of the treatment technology of percutaneous transhepatic biliary drainage ( PTBD ) and percutaneous transhepatic insertion of biliary stent ( PTIBS ) for malignant biliary obstruction.Methods: PTBD and PTIBS were done for 172 patients of malignant biliary obstruction under X - ray image.The total bilirubin and direct bilirubin were measured for all patients at 10 day after operation.Results: The outward drainage were done for 123 patients and the inward drainage were done for 34 patients.The stents were applied for 15 patients in this study.The operation success rate was 100％.The total bilirubin and direct bilirubin of all patients were obviously declined after treatment.There was statistical significant difference in liver function ( P ＜ 0.005 ).Conclusion: PTBD and PTIBS were effective method for malignant biliary obstruction and the treatment was small trauma, simple operation and high security.%目的:探讨经皮经肝胆管引流术(percutaneous transhepatic biliary drainage,PTBD)和经皮经肝胆管内支架引流术(percutaneous transhepatic insertion of biliary stent,PTIBS)治疗恶性梗阻性黄疸的技术,疗效及并发症.方法:172例恶性胆道梗阻患者在影像监视下行PTBD或PTIBS,术后10天复查血清总胆红素和直接胆红素.结果:172例恶性胆道梗阻患者,行外引流者123例,行内外引流者34例,行胆道支架置入者15例.技术操作成功率100%.所有患者术后第10天血清总胆红素和直接胆红素明显下降,肝功能改善,差异有统计学意义(P＜0.005).结论:PTBD和PTIBS是治疗恶性梗阻性黄疸的有效方法,具有创伤小、操作简便、安全性高的优点.