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目的探讨经皮肝穿刺胆管内射频消融联合金属支架植入术治疗恶性梗阻性黄疸的安全性和有效性。方法回顾性分析了156例无法手术的恶性胆道梗阻患者的资料。这些患者首先接受经皮肝穿刺胆管内射频消融术,随后联合胆道内金属支架植入进行内引流。结果经联合治疗后,患者除血清白蛋白下降外,其他主要肝功能指标均显著改善,TBil由治疗前的(325.6±182.3)μmol/L下降到(211.0±153.2)μmol/L,均未发生肝功能不全,30 d内无一例患者死亡。术后发生严重并发症8例,其中胆漏2例(1.3%),出血6例(3.9%);发生轻微并发症88例,其中胆道感染22例(14.3%),疼痛36例(23.4%),呕吐30例(19.5%)。结论经皮肝穿刺胆管内射频消融联合金属支架植入术治疗恶性胆道梗阻是安全,有效的。
Objective To investigate the safety and efficacy of percutaneous transhepatic bile duct radiofrequency ablation combined with metal stent implantation in the treatment of malignant obstructive jaundice. Methods A retrospective analysis of 156 cases of inoperable malignant biliary obstruction in patients with the data. These patients first underwent percutaneous transhepatic bile duct radiofrequency ablation followed by intraductal metal stent implantation for internal drainage. Results After the combination therapy, all the major indexes of liver function were significantly improved except serum albumin. The TBil decreased from (325.6 ± 182.3) μmol / L to (211.0 ± 153.2) μmol / L before treatment Hepatic insufficiency, none of the patients died within 30 days. There were 8 cases of serious complications after operation, including 2 cases of bile leakage (1.3%) and 6 cases of bleeding (3.9%). There were 88 minor complications including 22 cases of biliary tract infection (14.3%), 36 cases of pain (23.4% ), Vomiting in 30 cases (19.5%). Conclusion Percutaneous transhepatic bile duct radiofrequency ablation combined with metal stent implantation for the treatment of malignant biliary obstruction is safe and effective.