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您现在的位置:首页 => 在线期刊 => 2015年 5期 胰腺疾病 => 胆道疾病 =>经皮肝穿刺胆道腔内射频消融联合胆..
经皮肝穿刺胆道腔内射频消融联合胆道支架治疗恶性胆道梗阻的临床观察
Efficacy of percutaneous intraductal radiofrequency ablation combined with biliary stenting in treatment of malignant biliary obstruction
文章发布日期:2015年04月15日  来源:  作者:张凯,张萌帆,任建庄,等  点击次数:1406次  下载次数:319次

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【摘要】:目的探讨经皮肝穿刺胆道腔内射频消融技术姑息性治疗恶性梗阻性黄疸的安全性及可行性。方法选取2013年1月-2014年3月接受治疗的20例无法切除的恶性梗阻性黄疸患者作为实验组,其中9例不能外科手术切除患者透视下行经皮肝穿刺胆道腔内射频消融术,并留置金属胆道支架;同期随机纳入11例相似病情患者作为对照组,经皮肝穿刺胆道造影(PTC)成功后仅行胆道支架置入。观察两组手术并发症及黄疸缓解情况,密切随访并比较术后3和6个月支架的通畅性。结果所有患者术后通过门诊或电话均获得完整随访。实验组及对照组术后3个月支架通畅率分别为100%,727%(χ2=2.888,P=0.218),术后6个月支架通畅率分别为:875%、273%(χ2=6.739,P=0.02)。随访期内射频组1例患者于术后113 d死于消化道出血,对照组1例患者于57 d死于肝功能衰竭,1例患者于术后142 d死于弥散性血管内凝血。结论经皮肝穿刺胆道腔内射频消融对恶性胆道梗阻的治疗是安全和可行的,在延长自膨式金属支架通畅性方面初步疗效令人满意,但尚需大量样本随机对照研究进一步验证。
【Abstract】:ObjectiveTo investigate the safety and feasibility of percutaneous intraductal radiofrequency ablation (palliative therapy) in the treatment of malignant obstructive jaundice. MethodsThis study included 20 patients with unresectable malignant obstructive jaundice, who were treated in the First Affiliated Hospital of Zhengzhou University from January 2013 to March 2014. Nine of them (test group) underwent percutaneous intraductal radiofrequency ablation plus metallic biliary stent placement. The other 11 similar cases (control group) underwent metallic biliary stent placement alone after successful percutaneous transhepatic cholangiography. Operative complications and remission of jaundice were observed, and the stent patency after at 3 and 6 months after operation was evaluated and compared between the two groups. ResultsAll patients were followed completely by outpatient or telephone. The stent patency rate at 3 months after operation was 9/9 in the test group and 8/11 in the control group (χ2=2.888, P=0.218), and the stent patency rates at 6 months were 7/8 and 3/11, respectively (χ2=6.739, P=0.02). During follow-up, one case in the test group died of gastrointestinal bleeding at 113 d after operation; one case in the control group died of liver failure at 57 d after operation and one case died of disseminated intravascular coagulation at 142 d. ConclusionPercutaneous intraductal radiofrequency ablation is safe and feasible in the treatment of malignant biliary obstruction, and the preliminary efficacy in prolonging the patency of self-expanding metallic stent is satisfactory. However, this therapy needs to be further verified via large-sample randomized controlled studies.
【关键字】:胆汁淤积;导管消融术;支架
【Key words】:cholestasis; catheter ablation; stents
【引证本文】:

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