恶性梗阻性黄疸的双介入治疗

目的：本文通过双介入法（经皮经肝胆道引流术和经动脉化疗栓塞术）在恶性梗阻性黄疸病人治疗中的研究，对双介入法作一评价。材料和方法：我院从１９８７年至１９９６年共有８２例恶性梗阻性黄疸病人接受了介入治疗。其中２８例为单纯的经皮经肝道引流术（ＰＴＢＤ），归为Ａ组；另外５４例在ＰＴＢＤ术后２周左右接受了经动脉化疗术（ＴＡＩ）和／或化职栓塞术（ＴＡＩ＋ＴＡＥ），归为Ｂ组。所有病人都通过多种影象学，外科或生物

Dual Interventional Treatment of Malignant Obstructive Jaundice:Combined Percutaneous Transhepatic Biliary Drainage and Transarterial Chemotherapy

Objective:The purpose of this study was to evaluate the role of the combination of percutaneous transhepatic biliary drainage(PTBD)and the transarterial chemotherapy for the treatment of malignant obstructive jaundice.Materials and Methods:From 1987 June to 1996 June,total 82 cases of malignant obstructive jaundice were successfully treated by the combined method,of 28 cases were treated by PTBD alone(group A),and another 54 cases were received the transarterial infusion chemotherapy or/and chemoembolization about two weeks after the PTBD(group B).All patients were diagnosed to be advanced malignant tumor by multiple imagings,surgery as well as biopsy.All patients had been followed up.The efficacies of the two groups were compared.Results:After PTBD,serum bilirubin level in all patients were remarkably declined and liver function recovered within 15-20 days.In group A, mean survival period was 3.6 months,and no patient lived longer than 6 months without recanalization of biliary obstruction.In group B,mean survival period was 10.2 months with recanalization of biliary obstruction shown in 31 cases(57.4%)following 2-4 times of TAI and/or TAE.9 of those cases were free of jaundice for 5-51 months after withdrawn of drainage catheter.No significant difference between the 2 groups in complications.Conclusion:PTBD combined with transarterial chemotherapy is a safe and effective method for the treatment of malignant obstructive jaundice.Comparing the efficiency of PTBD alone,it can improve pa- tients' life quality and raise the survival rate.It may provide more easy approach to implant the biliary metal stent.