目的:探讨同轴导管技术在胰头癌致严重胆道梗阻中的应用,为临床推广提供参考.方法:20例患者术中以普通导丝疏通失败.以同轴导管技术顺利越过梗阻段,然后于梗阻平面顺利释放胆道支架.术后观察患者并发症及入院相关临床症状改善情况;观察术后1月复查的肝功情况并和术前比较;术后1月行腹部B超、CT或MRI了解胆道及支架情况.结果:20例患者均成功疏通狭窄段,术后2例出现寒战发热及疼痛症状,给予抗感染及镇痛处理后好转.术后1月复查肝功,和术前比较,差异有统计学意义(P＜0.05),20例患者术后皮肤巩膜黄染、厌油纳差及皮肤瘙痒等入院相关症状均明显改善.术后1月,患者于门诊行腹部B超、CT或MRI提示:20例患者肝内外胆道均无明显扩张,胆道支架顺畅在位.结论:同轴导管技术可提升严重胆道梗阻的成功率,在临床工作中值得尝试及推广.%Objective:To explore the application of coaxial catheter technology in severe biliary obstruction caused by pancreatic head cancer,and to provide reference for clinical application.Methods:Twenty cases failed in dredging with common guide wire.But they were successfully dredged with coaxial catheter.The biliary stents were then successfully released at the obstruction plane.Complications and improvement of clinical symptoms associated with hospitalization were observed.The liver function was reviewed in 1 month later after operation and compared with preoperative.Abdominal ultrasound,CT or MRI were performed to know the situation of biliary and stent a month later.Results:All 20 patients were dredged successfully.Chills,fever and pain were present in 2 patients after the operation,and improved after anti-infection and analgesia treatment.Reviewed liver function a month later,and compared with preoperative,the difference was statistically significant(P＜0.05).The related symptoms of jaundice,tired of the oil and skin itching were improved obviously in 20 cases after the operation.A month later,abdominal ultrasound,CT or MRI showed that the intrahepatic and extrahepatic bile ducts without obvious dilatation in 20 cases.The biliary stents were unobstructed and in good position.Conclusion:Coaxial catheter technique can improve the success rate of severe biliary obstruction.It is worth trying and popularizing in clinical work.
展开▼
