摘要
目的探讨单纯胆道内支架植入术后和内支架植入术后联合靶向性灌注化疗栓塞对晚期恶性梗阻性黄疸患者介入治疗中的疗效,并加以研究比较。方法选取2006年12月至2010年12月于我科治疗的105例晚期恶性梗阻性黄疸患者做为回顾性分析研究对象并随机分成对照组和观察组,其中对照组采用的是单纯胆道内支架置入术进行治疗,共45例患者;而观察组则采用的是胆道支架置入+靶向性动脉灌注化疗栓塞术进行双途径介入治疗,该组患者共60例。并对术后两组患者的血清总胆红素(TBIL)的变化情况、碱性磷酸酶(ALP)的变化情况、再梗阻间隔时间及生存时间进行比较分析。结果观察组与对照组患者术后4-6周较术前TBIL与ALP均明显减退,但两组之间比较变化二者无统计学差异(P>0.05)。内支架置入术后联合进行经动脉靶肿瘤灌注化疗栓塞患者术后发生再梗阻的时间及患者的生存期均显著长于对照组患者(P<0.05)。结论胆道内支架成形术是目前国际上公认的姑息性治疗晚期恶性梗阻性黄疸的最有效方法之一。恶性肿瘤经动脉灌注化疗栓塞是血管介入领域重要的组成部分,能有效的控制和减缓肿瘤的生长,甚至使肿瘤体积缩小。胆道内支架植入术后联合靶向性灌注化疗栓塞,能有效增加支架的使用效率和使用时间,延长患者的术后相对高质量生存期,更加具有优势。
Objective To investigate the efficacy of percutaneous transhepatic biliary tract stent implantation with or without transcatheter arterial chemoemblization in the treatment of advanced malignant biliary obstructive jaundice. Methods The clinical data of 105 cases with advanced malignant biliary obstructive jaundice in my hospital from December 2006 to December 2010 were retrospectively analyzed. Control group （n=45cases） was treated with percutaneous transhepatic biliary tract stent implantation alone, while experimental group（n=60cases） was treated with the combination of percutaneous transhepatic biliary tract stent implantation and subsequent transcatheter arterial chemoemblization. The time of jaundice disappearance, the change of total bilirubin and alkaline phosphatase level, the interval time before the obstruction recurred, survival time in two treatment groups were statistically analysed. Results No significant differences could be found for the change of total bilirubin and alkaline phosphatase level between two treatment groups （P〉0.05）. But the interval timebefore the obstruction recurred and survival time in the experimental group were significantly longer than that in control group expectively （P〈O.05）. Conclusion Percutaneous transhepatic biliary tract stent implantation is regarded as one of the most effective palliative methods in the treatment of advanced malignant biliary obstructive jaundice internationally.Transcatheter arterial chemoemblization is an essential part of vascular invention to malignant tumor which can control or slow tumor growth, and even decrease the tumor volume to some extent. A combination of percutaneous transhepatic biliary tract stent implantation and transcatheter arterial chemoemblization can extend the patency time of stentt, and accordingly prolong the comparatively high quality life time of the patient after procedure.
出处
《医学研究与教育》
CAS
2012年第1期36-40,共5页
Medical Research and Education
关键词
恶性梗阻性黄疸
胆道内支架
化疗栓塞
malignant biliary obstructive
biliary stent
arterial chemoemblization
