摘要
目的:评价胆道支架置入术治疗胆道恶性梗阻的价值。方法:135例胆道恶性梗阻患者,应用经皮肝穿胆道造影及支架置入技术,其中87例合并动脉内化疗或化疗栓塞术,48例单纯应用支架置入术。结果:单支置入128例,双支置入7例。支架置入术成功率为99.3%(成功植入142支/首次预计植入143支)。黄疸完全缓解率86.7%(117/135),总有效率97.8%(132/135)。6个月、12个月及24个月生存率分别为71.1%(96/135)、43.7%(59/135)及11.9%(16/135),联合抗肿瘤治疗与单纯支架治疗12个月生存率分别为:54.0%(47/87)及25.0%(12/48),统计学处理有显著性差异(χ2=10.59,P<0.001)。支架再狭窄或阻塞21例,经皮穿刺外引流或支架内再置入支架治疗,黄疸再次消失。结论:胆道支架置入术减黄疗效肯定,与抗肿瘤治疗联合应用可提高患者生存率。
Objective: To evaluate the value of biliary stents in treatment of malignant obstruction of the bile duct. Methods: Percutaneous transhepatic cholangiography and stent insertion were performed in 135 patients with malignant biliary obstruction. Intraarterial chemotherapy or transcatheter arterial chemo-embolization were adopted for 87 out of the 135 patients. Results: Single stent was inserted in 128 cases and 2 stens inserted in 7 cases (biliary stent in 5 cases and duodenum stent in 2 cases). The successful rate of stent inserting technique was 99.3%(142/143), jaundice disappearing rate 86.7%(117/135) and total effective rate 97.8%(132/135). The 6,12 and 24 months survival rates of these patients were 71.1%(96/135), 43.7%(59/135) and 11.9%(16/135) respectively. 12 months survival rate was 54.0%(47/87) and 25.0%(12/48) in the combined treatment group and simple stenting group respectively. There was significant difference in 12 months survival rate between the two groups(χ2=10.59 P<0.001). For the 21 patients with stent restenosis, 15 were managed with stenting in the stent, 7 with drainage through percutaneous puncture, and jaundice faded again. Conclusions: Biliary stent placement are an efficient means of treating malignant biliary obstruction and reducing the level of serum bilirubin. Stent insertion combined with different anti-cancer treatments can increase 12 months survival rate in the patients.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2004年第2期86-88,共3页
Chinese Journal of Clinical Oncology
关键词
放射学
介入性
内支架
胆管阻塞
Radiology Interventional Stent Biliary obstruction
