胆道支架联合^(125)I粒子条植入治疗恶性梗阻性黄疸  

Biliary stenting combined with liner ^(125)I seed implantation in treatment of malignant obstructive jaundice

作　　者：任伟超[1] 王彦华[1] 孙成建[1] 解玲玲[1] 刘彤晖[1] 王承恩[1] 

机构地区：[1]青岛大学附属医院介入医学科,山东青岛266003

出　　处：《中国介入影像与治疗学》2015年第8期463-467,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨胆道支架联合125I粒子植入治疗恶性梗阻性黄疸的疗效及安全性。方法收集我科收治的无法手术切除的恶性梗阻性黄疸患者47例,20例患者接受胆道支架植入治疗,另外27例给予胆道支架联合125I粒子条植入治疗,对所有患者随访1~20个月,记录患者的生存时间,并进行生存分析,于术后1、2周检测肝功指标水平变化。结果所有患者手术成功率100%,术后出现急性胰腺炎患者2例、胆道感染1例、胆汁性腹膜炎2例,未发生放射性泄漏、放射性肠炎等并发症,1个月后复查粒子条移位2例。单纯支架植入和支架联合125I粒子条植入患者的中位生存时间分别是158天(95%CI 135.96~180.04),279天(95%CI 189.59~368.41);平均生存时间分别是172天(95%CI 115.29~228.47)和284天(95%CI 224.53~342.80),两组差异均有统计学意义(P均<0.05)。结论胆道支架联合125I粒子条植入安全可靠、疗效肯定,能有效延长患者的生存期。Objective To evaluate the clinical efficacy and safety of biliary stenting combined with liner ^125I seed implantation in treating malignant obstructive jaundice （MOJ）. Methods Totally 47 patients with unresectable malignant obstructive jaundice received stents insertion and 27 patients also received liner ^125I seed implantation. All the patients were followed-up for 1 to 20 months, and the survival time of each patient were recorded, the accumulated survival rate was analyzed by means of Kaplan-Meier. Changes of liver function indexes at 1 week and 2 weeks following the surgery were tested. Results Operation successful rate was 100% and after the operation there were acute pancreatitis in 2 cases, the infection of biliary duct in 1 case, bile peritonitis in 2 cases, and no radioactive particles leaking or complications such as radiation enteritis occurred. Displacement of the liner 125I seeds were observed in 2 cases. Medlian survival time of group only received stents insertion and received biliary stenting combined with linear ^125I seeds implanted were 158 days （95% CI 135.96-180. 04） and 279 days （95%CI 189.59-368.41, P〈0.05） ; the mean survival time of group only received stents insertion and received biliary stenting combined with linear ^125I seeds implanted were 172 days （95 % CI 115.29-228.47） and 284 days （95%CI 224.53-342.80, P〈0.05）. Conclusion Biliary stenting combined with liner ^125I seed implantation in treatment of unresectable malignant obstructive jaundice is safe, reliable and effective, it can prolong the patient＇s survival time.

关 键 词：支架 黄疸 梗阻性 ^125I粒子 

分 类 号：R730.5[医药卫生—肿瘤]