目的 :分析经皮经肝胆道引流 (PTBD)并药盒系统介入化疗分步治疗巨大胰头癌的效果。方法 :4 0例大胰头癌 ( >6cm ,均伴有黄疸 )患者随机分成 2组 :A组 30例采用综合介入治疗 ,先行B超及X线辅助下的PTBD以减轻黄疸 ,恢复肝功能。 10d～ 1个月后进行胃、十二指肠动脉药盒系统植入介入化疗 ,通过药盒定期给予 5 氟脲嘧啶、丝裂霉素、阿霉素化疗。B组 10例作为对照在PTBD术后 10d～ 1个月采用静脉全身化疗 ,化疗方案同A组。结果 :4 0例患者均行PTBD ,患者血清总胆红素水平术后 1个月和 3个月分别下降 161± 2 9μmol/L和 2 61± 92cμmol/L ,转氨酶逐渐降至正常 ,A组 30例患者共行局部药盒系统化疗3～ 10次 ,平均 8 2次 ,完全缓解 (CR) 1例 ,部分缓解 (PR) 2 0例 ,有效率 70 % ,生存期 3～ 34个月 ,中位生存时间 13 5个月 ,所有患者症状均有不同程度好转 ,未发生严重并发症或者毒副反应。B组完成化疗 1～ 7次 ,平均 3 8次。无完全缓解病例 ,部分缓解 2例 ,有效率为 2 0 % ,生存期 1～ 13个月 ,中位生存时间 6 2个月。两组对比有效率和生存期差异显著。结论 :综合介入治疗大胰头癌效果好 ,患者生存期与生存质量均得到明显改善 OBJECTIVE: To analyze the effect of percutaneous transhepatic biliary drainage (PTBD) and the kit-of-system interventional chemotherapy in the treatment of giant pancreatic head cancer. Methods: Forty patients with large pancreatic head cancer (> 6cm, both with jaundice) were randomly divided into two groups: Group A (30 cases) were treated with comprehensive interventional therapy. First, B-mode ultrasound and X-ray assisted PTBD were used to relieve jaundice and restore liver function . 10d ~ 1 months after the stomach, duodenal arterial kit implantation interventional chemotherapy through the kit regularly given 5-fluorouracil, mitomycin, doxorubicin chemotherapy. Ten patients in group B received intravenous systemic chemotherapy 10 days to 1 month after PTBD. The chemotherapy regimen was the same as that of group A. Results: All 40 patients underwent PTBD. The level of serum total bilirubin decreased by 161 ± 29μmol / L and 2161 ± 92cμmol / L at 1 month and 3 months after operation respectively, and the level of aminotransferase gradually decreased to normal in group A Thirty patients underwent partial chemo-system chemotherapy 3 to 10 times on average, 8 cases on average, 1 complete remission (CR) and 20 partial remission (PR), the effective rate was 70%, the survival time was 3 to 34 months, The median survival time of 13 5 months, all patients have improved in varying degrees symptoms, no serious complications or side effects. B group completed chemotherapy 1 to 7 times, an average of 38 times. No complete remission cases, partial remission in 2 cases, the effective rate was 20%, the survival of 1 to 13 months, the median survival time of 6 2 months. There was significant difference between the two groups in effective rate and survival. Conclusion: The comprehensive interventional treatment of large pancreatic cancer has a good effect, patients’ survival and quality of life have been significantly improved