摘要
目的 评价胆道支架技术对恶性胆道梗阻的应用价值 ,该技术 5年来的创新及联合抗肿瘤治疗的意义。方法 2 13例胆道恶性梗阻病人 ,采用经皮经肝胆道造影及支架植入术。 10 4例支架植入后并用抗肿瘤治疗。结果 单支架植入 14 2例 ,双支架植入 6 8例。支架植入成功率 98 6 %。黄疸完全解除率 84 8% ,总有效率 95 9%。支架并抗肿瘤治疗 89例与单纯支架植入 5 1例 1年生存率分别为 4 8 3%和 17 6 % ,χ2 =11 2 2 ,P =0 0 1;两年生存率为 14 6 %和 5 9% ,χ2 =3 0 1,P =0 10。支架再阻塞 5 2例 ,4 0例给予动脉化疗栓塞、经皮穿刺外引流或支架内支架治疗 ,黄疸再度消退。结论 (1)胆道支架植入技术成功率高 ,减黄疗效确切。 (2 )应用介入方法可实现梗阻胆管的充分引流和处理支架再狭窄。 (3)支架植入联合抗肿瘤治疗可提高病人生存率。
Objective To determine the value of biliary stents in treatment of malignant obstruction of the bile duct, illustrate the technical innovation in the past 5 years and study the therapeutic significance of it used in combination with anti cancer treatments. Methods Percutaneous transhepatic cholangiography and stent insertion were performed in 213 patients with malignant biliary obstruction. Anti cancer treatments were adopted for 104 out of the 213 patients. Results Single stent was inserted in 143 patients and 2 stents inserted in 68. The successful rate of stent insertion was 98 6%, jaundice disappearing rate 84 8% and total effective rate 95 9%. One year survival rate was 48 3% and 17 6% in the combined treatment group and simple stenting group, respectively. The 2 year survival rate was 14 6% and 5 9% respectively in the 2 groups. There was significant difference in 1 year survival rate between the two groups. For the 52 patients with stent restenosis, 40 were managed with artery chemoembolization, drainage through percutaneous puncture or stenting in the stent and jaundice faded again. Conclusions 1) Biliary stent placement has high successful rate and reliable efficacy in releasing jaundice. 2) Both the left and right ductal system can be sufficiently drained and stent occlusion appropriately managed by interventional procedures. 3) Stent insertion combined with different anti cancer treatments can increase 1 year survival rate in the patients.
出处
《中华肝胆外科杂志》
CAS
CSCD
2002年第10期595-597,共3页
Chinese Journal of Hepatobiliary Surgery
