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目的探讨通过纤维十二指肠镜逆行胆胰管造影(ERCP)放置胆道内支架治疗晚期恶性胆道梗阻的临床疗效。方法 32例恶性梗阻性黄疸的患者,均行ERCP(经内镜逆行胰胆管造影)术,根据情况置入不同支架,观察其疗效和3个月6、个月生存率。结果 30例患者插管成功,插管成功率93.8%。其中18例置入金属支架,12例置入塑料支架。发生并发症2例(3.33%),其中急性胰腺炎1例,胆管炎1例。以上2例均经治疗后痊愈出院,术后黄疸逐渐消退,皮肤瘙痒等症状消失或减轻。插管成功的30例患者血清总胆红素从(170.84±101.72)μmol/L下降到术后1周(105.42±82.44)μmol/L(P<0.01),支架组随访21例中总体3个月6、个月存活分别达到93%及79%。结论 30例患者插管成功,插管成功率93.8%。其中18例置入金属支架,12例置入塑料支架。发生并发症2例(3.33%),其中急性胰腺炎1例,胆管炎1例。以上2例均经治疗后痊愈出院,术后黄疸逐渐消退,皮肤瘙痒等症状消失或减轻。插管成功的30例患者血清总胆红素从(170.84±101.72)μmol/L下降到术后1周(105.42±82.44)μmol/L(P<0.01),支架组随访21例中总体3个月、6个月存活分别达到93%及79%。
Objective To investigate the clinical efficacy of biliary stent placement in the treatment of advanced malignant biliary obstruction by retrograde cholangiopancreatography (ERCP). Methods Thirty-two patients with malignant obstructive jaundice were treated with ERCP (endoscopic retrograde cholangiopancreatography). According to the situation, different stents were placed and their curative effect and the 6-month and 3-month survival rates were observed. Results 30 cases of successful intubation, intubation success rate of 93.8%. Among them, 18 cases were placed in metal stents and 12 cases were placed in plastic stents. Complications occurred in 2 cases (3.33%), of which 1 case of acute pancreatitis, cholangitis in 1 case. More than 2 cases were cured after treatment were discharged, postoperative jaundice subsided, the skin itching and other symptoms disappeared or reduced. The total serum bilirubin in 30 patients with successful intubation decreased from (170.84 ± 101.72) μmol / L to (105.42 ± 82.44) μmol / L in one week after operation (P <0.01) Month 6, month survival respectively 93% and 79%. Conclusion 30 cases of successful intubation, intubation success rate of 93.8%. Among them, 18 cases were placed in metal stents and 12 cases were placed in plastic stents. Complications occurred in 2 cases (3.33%), of which 1 case of acute pancreatitis, cholangitis in 1 case. More than 2 cases were cured after treatment were discharged, postoperative jaundice subsided, the skin itching and other symptoms disappeared or reduced. The total serum bilirubin in 30 patients with successful intubation decreased from (170.84 ± 101.72) μmol / L to (105.42 ± 82.44) μmol / L in one week after operation (P <0.01) Month, 6 months survival were 93% and 79%.