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23 例介入治疗恶性黄疸案例分析

Analysis of 23 cases of interventional treatment of malignant jaundice

临床医学前沿 / 2019,1(1)：1-6 / 2019-12-27 685 710

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• 作者： 周越生     
• 单位：

  深圳市人民医院，深圳

• 关键词： 梗阻性黄疸；介入放射学；经皮肝胆管引流术（VTBD）；经皮肝胆管支架放置术（PPBS）
• Obstructive jaundice; Interventional Radiology; percutaneous hepatobiliary drainage (VTBD); percutaneous stent placement (PPBS)
• 摘要： 目的：回顾性分析高龄恶性阻塞性黄疸患者的介入治疗方法和近期疗 效以及影响黄疸消退的因素。方法 23 例 65 岁以上患者，男 15 例，女 8 例，平 均 72.1 岁。其中肝癌 5 例，胆管癌 8 例，胆囊癌 2 例，胰腺癌 6 例，转移癌 2 例。梗阻部位在胆总管 9 例，肝总管肝门区以上 14 例。9 例单纯外引流或内外 引流，14 例放置了胆道支架，术后 1 周造影复查。术前、术后查血生化，分析 影响黄疸消退的因素。结果复查时引流通畅，支架扩张良好。黄疸消退明显 16 例，比较明显 2 例，不明显 5 例。患者胆红素由（345.13±127.21）μmol/L 降 至（215.54±124.58）μmol/L。引流术后早期出现并发症 13 例，死亡 1 例。结 论介入治疗恶性黄疸方法简单、疗效确切。但对高龄患者治疗时应严格掌握其 适应证。
• Objective: to analyze the interventional therapy and its short-term effect in the elderly patients with malignant obstructive jaundice and the factors influencing the regression of jaundice. Methods 23 patients over 65 years old, 15 males and 8 females, average 72.1 years old. There were 5 cases of liver cancer, 8 cases of cholangiocarcinoma, 2 cases of gallbladder cancer, 6 cases of pancreatic cancer and 2 cases of metastatic cancer. There were 9 cases in the common bile duct and 14 cases in the hilar area of the common hepatic duct. 9 cases were treated only by external drainage or internal and external drainage, 14 cases were treated with biliary stent, and one week after operation, the angiography was reexamined. Before and after the operation, blood biochemical examination was performed to analyze the factors influencing the regression of jaundice. Results the drainage was unobstructed and the stent expanded well. Jaundice subsided obviously in 16 cases, obviously in 2 cases and not obviously in 5 cases. The bilirubin of patients decreased from (345.13 ± 127.21) mol / L to (215.54 ± 124.58) mol / L. There were 13 complications and 1 death in the early stage after drainage. Conclusion interventional therapy for malignant jaundice is simple and effective. But the indications of the elderly patients should be strictly controlled.
• DOI： https://doi.org/10.35534/fcm.0101001c
• 引用： 周越生．23 例介入治疗恶性黄疸案例分析［J］．临床医学前沿，2019，1（1）：1-6．