摘要
目的 探讨左右叶双侧PTBD术治疗高位恶性梗阻性黄疸患者及疗效影响因素。方法 回顾性分析我院 2 0 0 1年 1月至 2 0 0 3年 3月 2 7例高位恶性梗阻性黄疸行左右叶双侧PTBD术的患者 (男∶女 =2 .3 8∶1,平均年龄 5 2 .8岁 ) ,纳入标准为胆总管上段梗阻行左右叶双侧PTBD术并且术后随访 4周。以术后四周血清总胆红素是否下降 5 0 %分为两组。比较两组原发疾病、术前Child Pugh评分、行PTBD术和临床症状出现时间间隔、左右叶PTBD时间间隔及术中胆道造影显示梗阻类型。结果 2 7例患者术后血清总胆红素下降大于 5 0 %有 18例 ,小于 5 0 %有 9例。两组病例在PTBD术距离临床症状出现时间及左右叶PTBD时间间隔之间存在统计学差异 ,而术前的血清总胆红素水平、Child Pugh评分及术后胆道感染无统计学差异。结论 左右叶双侧PTBD术治疗高位恶性梗阻性黄疸具有一定的近期疗效 ,早期引流与多支引流同样重要。
Objective To evaluate the therapeutic effect of bilateral percutaneous transhepatic biliary drainage (PTBD) in patients with obstructive jaundice caused by hilar biliary invaded by malignant tumor and to determine the factors effect the threatment outcome. Methods We retrospectively analyzed the data of 27 patients (M∶F=2.38∶1, mean age 52.8 years). Inclusion criteria were the patient having obstructive jaundice that malignant tumor invaded the hilar bile ducts and having at least 4 weeks of follow-up data after the PTBD. We defined 'good response' and 'poor response' as whether the level of total bilirubin decreased more than 50% in 4 weeks or not. Total bilirubin level (T-bil), Child-Pugh score,the interval between clinical onset of jaundice and PTBD, the interval between the right and left lobe intervention and the location of biliary obstruction for the two groups were compared. Results Of the 27 patients, 18 (66.7%) showed good response. The interval between clinical onset of jaundice and PTBD, the interval between the right and left lobe intervention show significant effect.the presence of and the size of the tumor did not show significant effect. Conclusion Early and effective biliary drainage might be necessary in this group of patients.
出处
《中国医学影像技术》
CSCD
2003年第12期1729-1732,共4页
Chinese Journal of Medical Imaging Technology
