经皮胆道金属支架治疗术对肝门部胆管癌患者的临床效果.docVIP

经皮胆道金属支架治疗术对肝门部胆管癌患者的临床效果 　　[摘要]目的 探讨经皮胆道金属支架治疗术对肝门部胆管癌患者的临床效果。方法 选择2011年1月～2014年12月我院收治的62例失去手术机会的肝门部胆管癌，在超声引导下行经皮胆道金属支架治疗术，1周后在DSA透视下行胆道金属支架植入。将经皮胆道金属支架治疗术的外引流转为胆道支架内引流。结果 62例患者共56例成功植入胆道支架，成功率为90.3%，56例患者血清总胆红素从术前的（290.3±170.0）μmol/L降至术后（108.2±62.0）μmol/L，血清直接胆红素术前（197.3±119.2）μmol/L，术后降至（49.2±19.4）μmol/L，丙氨酸氨基转移酶术前为（206.3±127.4）U/L，术后降至（80.1±55.8）U/L，天冬氨酸氨基转移酶从术前的（180.1±95.2）U/L降至（94.2±59.7）U/L，γ-谷氨酰转肽酶从术前的（756.8±302.1）U/L降至（230.1±101.5）U/L，甲胎蛋白从术前的（120.3±32.2）μg/L降至（98.2±10.8）μg/L。差异均有统计学意义（P0.05）。结论 经皮胆道金属支架治疗术能有效地改善肝门部胆管癌患者的肝功能，值得临床上推广使用。 　　[关键词]肝门部胆管癌；经皮胆道金属支架治疗术；甲胎蛋白；γ-谷氨酰转肽酶 　　[中图分类号] R735.8 [文献标识码] A [文章编号] 1674-4721（2017）10（b）-0056-03 　　[Abstract]Objective To investigate the clinical effect of percutaneous biliary metal stenting in patients with hilar cholangiocarcinoma.Methods A total of 62 patients with hilar cholangiocarcinoma who had lost the opportunity of surgical resection from January 2011 to December 2014 were selected.Percutaneous biliary metal stenting was carried out under the guidance of ultrasonography.After 1 week，the biliary metal stent implantation was performed under DSA fluoroscopy.The external drainage in the percutaneous biliary metal stenting was switched into the internal drainage within biliary stent.Results A total of 56 patients with hilar cholangiocarcinoma out of 62 patients were successfully implanted with biliary stent.The success rate was 90.3%.The serum total bilirubin in 56 patients with hilar cholangiocarcinoma was decreased from （290.3±170.0） μmol/L before the surgery to （108.2±62.0） μmol/L.The serum direct bilirubin was decreased from （197.3±119.2） μmol/L before the surgery to （49.2±19.4） μmol/L.Alanine aminotransferase was decreased from （206.3±127.4） U/L to （80.1±55.8） U/L after the surgery.Aspartate aminotransferase was decreased from （180.1±95.2） U/L to （94.2±59.7） U/L after the surgery.γ-glutamyl transpeptidase was decreased from （756.8±302.1） U/L to （230.1± 101.5） U/L.AFP was decreased from （120.3±32.2） μg/L