Abstract
目的 探讨胆道内支架植入术联合动脉药盒(PCS)植入局部化疗栓塞治疗恶性梗阻性黄疸的临床价值.方法28例均已不能或不宜行外科手术的恶性梗阻性黄疸病人,其中肝门原发性肿瘤14例,肝内转移性肝癌6例,胰头癌6例,胆管癌2例.28例患者随机分成二组,A组为单纯内支架治疗(EMBE);B组为先行经皮胆管引流内支架植入术,再按肿瘤生物学特征及药代动力学特点,经药盒泵入化疗药物.结果28例中27例胆管引流内支架植入术成功.其中1 3例为单纯胆管内支架植入术,14例在胆管内支架植入术后行PCS植入化疗随访1～12个月,EMBE组1～3个月内7例(占53.8%)出现再闭塞,2～6个月内死亡9例,占69.2%,1 2个月内死亡11例,占84.6%;EMBE+PCS组1～3个月内出现再闭塞3例,占27.3%,2～6个月内死亡3例,占21.4%,12个月内死亡5例,占35.7%,EMBE组与EMBE+PCS组的死亡率及再闭塞率相比,有显著性差异(P＜0.01).结论恶性梗阻黄疸EBME联合PCS治疗优于单纯EMBE治疗。
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