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目的:研究分析经十二指肠镜胆道金属支架置入术治疗恶性胆道梗阻性疾病的临床应用价值。方法:选择2008年10月~2014年6月期间本院收治的18例恶性胆道梗阻性疾病患者作为临床试验研究对象,所有患者均行以十二指肠镜下胆道金属支架(endoscopic metal biliary endoprothesis,EMBE)置入治疗,并对其临床效果进行分析。结果:参与本组实验研究的18例患者中,有17例行以内镜下胆道金属支架成功,成功率为94.40%,1例未成功是由于患者为十二指肠乳头癌,癌肿过于巨大促使操作空间过小,无法插管,该患者后行以PTCD引流术。内镜下胆道金属支架术后一周内血清胆红素恢复正常13例,占总比例的72.20%,明显下降4例,占总比例的22.20%,总有效率为94.40%;18例患者均获随访,随访时间为1~24个月,支架维持通畅时间平均为(9.60±2.40)个月;6个月和1年生存率分别为61.10%(11/18)和27.70%(5/18)。除1例患者黄疸指标无下降外,其他17例患者均在住院1W后出现不同程度的黄疸指标下降,且全身瘙痒感明显减轻,食欲增加。结论:对恶性胆道梗阻患者行以内镜下胆道金属支架的治疗方式,能够有效提高患者的生存几率与生活质量,临床疗效显著。此外,该手术具有手术创伤小、安全性高、经济性强等诸多优点,值得临床上广泛应用。
Objective: To study the clinical value of duodenoscopic biliary stent placement in the treatment of malignant biliary obstruction. Methods: 18 patients with malignant biliary obstruction admitted to our hospital from October 2008 to June 2014 were enrolled in this study. All patients underwent endoscopic metal biliary endoprosthesis , EMBE) into the treatment, and analyze its clinical effect. Results: Among the 18 patients participating in the experimental study, 17 cases were successfully treated with endoscopic biliary metal stent with a success rate of 94.40%. One unsuccessful patient was duodenal papillary carcinoma and the tumor size was too large Promote the operating space is too small, can not intubation, the patient after the line to PTCD drainage. Serum bilirubin returned to normal in 13 patients (72.20% of the total), decreased significantly in 4 patients (22.20% of the total) and the total effective rate was 94.40% within one week after operation. All 18 patients The follow-up time ranged from 1 to 24 months. The mean duration of stent patency was (9.60 ± 2.40) months. The 6-month and 1-year survival rates were 61.10% (11/18) and 27.70% (5/18) . In addition to 1 patient jaundice index no decline, the other 17 patients were hospitalized 1W after different degrees of jaundice decreased, and systemic itching significantly reduced appetite increased. Conclusion: The treatment of patients with malignant biliary obstruction by endoscopic biliary metal stent can effectively improve the survival rate and quality of life of patients with significant clinical effect. In addition, the operation has the advantages of less surgical trauma, high safety and economy, and is worth widely used clinically.