目的: 探讨恶性梗阻性黄疸胆道支架置入的临床疗效及并发症的发病原因及相应的处理方法。方
法: 我院2009－01 ～ 2011－01 的80 例恶性梗阻性黄疸病人，经逆行胰胆管造影并胆道支架置入术进行介入治疗。
术前术后检测血常规、TBil、DBil、GGT( γ－谷氨酰转移酶) 、血清中糖抗原19－9( CA 19－9) 。记录临床症状的变
化及并发症，术后常规随访，观察各种并发症的发生情况并给予针对性的处理。结果: 病人1 次支架置入成功数
为74 例( 92． 5%) 。有4 例病人行2 次支架置入成功，2 例失败。病人的黄疸消失时间( 6． 1±1． 5) d，皮肤瘙痒消
失时间( 3． 0±0． 3) d。术后5 例并发胆道出血，未有病人出现感染。治疗后血清总胆红素、GGT、CA 19－9 均呈下
降趋势，病人在治疗前后的血清总胆红素、GGT、CA 19－9 差异有统计学意义( P＜0． 05) ，治疗后3d 和1wk 的血清
总胆红素值显著低。治疗后随访6mo ～ 2a，平均( 12． 4±6． 3) mo，半年内死亡29 例，半a 至1a 死亡7 例，1a 至1a
半死亡10 例，1a 半至2a 死亡5 例。其余29 例病人随访至今均存活。有2 例病人出现胆管炎，并发症发生率
为2． 3%。未有病人出现气胸、导管脱位、胆汁性腹膜炎等并发症。结论: EＲCP 并胆道支架置入术治疗恶性梗
阻性黄疸，可明显延长恶性梗阻性黄疸病人的生存时间，是一种相对合理的选择。通过对各种并发症的发生原
因进行分析，积极防治并发症，可提高病人的生存时间，改善其生命质量。

Objective: To discuss clinical efficacy of biliary stent placement in the treatment of malignant
obstructive jaundice，and the causes of the complications and relative treatment method． Methods:
80 cases of malignant obstructive jaundice patients in our hospital from 2009 January to 2011 January
were treated with endoscopic retrograde cholangiopancreatography and biliary stent for interventional
therapy， in addition to anti －infection，hemostasis and symptomatic treatment． Preoperative and
postoperative blood routine，TBil，DBil，GGT( gamma glutamyl transferase) ， serum carbohydrate antigen
19－9( CA 19－9) ，GGT( gamma glutamyl transferase) were measured． The changes of clinical symptoms
and complications were recorded，various complications were observed and given targeted treatment．Results:
74 patients had successful stent implantation at one times( 92． 5%) ． There were 4 patients with 2
stents and successfully treated and 2 patients failed． The jaundice disappearance time was( 6． 1±1． 5)
d， skin itching disappeared time was ( 3． 0 ±0． 3) d． After operation 5 cases had complications with
biliary tract bleeding，no infection occurred in patients． After treatment， serum total bilirubin，GGT，CA
19－9 were decreased，with statistical significance ( P ＜0． 05) ． Serum total bilirubin after 3 d and 1
weeks of the treatment were significantly lower． Follow－up time was 6months to 2 years， the averaged
time was( 12． 4±6． 3) months． 29 patients died within six months，half a year with 1 years，7 cases with
half to 1 years，10 cases with 1 and 1． 5 years，5 cases with 1． 5 to 2 years． The rest of the patients
were followed－up and survived． 2 cases had cholangitis，and the accurance rate of complication was
2． 3%． Pneumothorax，catheter dislocation and bile peritonitis were observed in no of these patients．
Conclusion: ERCP combined with biliary stent for malignant obstructive jaundice can obviously prolong
the survival of patients with malignant obstructive jaundice，and it is a relatively reasonable choice． Analysis
of complications causes，active prevention of complications can improve the survival time of patients，
and improve their quality of life．

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