胆道支架及胆道支架联合^(125)I粒子条植入治疗胆管癌伴阻塞性黄疸疗效评估  

Clinicall efficacy evaluation of biliary stent versus biliary stent combined with ^(125)I-seed bar implantations for the treatment of cholangiocarcinoma with obstructive jaundice

作　　者：姜浩[1] 赵辉[1] 赵苏鸣[1] 顾潍炜 杨晓虎[1] 顾祝新[1] 黄健[1] 

机构地区：[1]南通大学附属医院介入放射科,江苏南通226001

出　　处：《中国临床研究》2015年第11期1425-1428,共4页Chinese Journal of Clinical Research

基　　金：江苏省南通市科技局应用研究计划项目(BK2013068)

摘　　要：目的评价胆道支架及胆道支架联合125I粒子条植入治疗胆管癌伴阻塞性黄疸的临床疗效。方法采用回顾性分析方法,收集南通大学附属医院2007年1月至2013年7月确诊胆管癌伴阻塞性黄疸54例患者的临床资料,根据治疗方式的不同,以在胆道内植入胆道支架及125I粒子条治疗者作为观察组(n=30),仅在胆道内植入支架治疗者作为对照组(n=24),分别对其疗效进行分析。结果两组患者均成功植入胆道支架或胆道支架联合125I粒子条,术后造影胆道通畅,手术成功率100%;两组术后皮肤瘙痒消失、大便转黄、总胆红素明显下降或降至正常;围术期未出现大出血、肝肾功能衰竭,未出现支架及粒子条移位。随访时间3~18个月,截止于2015年2月中旬,随访中8例失访;术后胆道通畅时间观察组[(8.7±0.7)个月]明显长于对照组[(6.2±0.4)个月,P<0.05];生存分析结果显示,生存时间观察组[(11.7±0.8)个月]亦明显长于对照组[(8.6±0.6)个月,P<0.05]。结论胆道支架联合125I粒子条植入是胆管癌伴阻塞性黄疸安全、有效的微创治疗方法。Objective To evaluate the curative effects of biliary stent combined with 125 I-seed bar implantations in bile duct and single biliary stent implantation in bile duct for the treatment of cholangioearcinoma with obstructive jaundice. Methods A total of 54 patients with cholangiocarcinoma complicated with obstructive jaundice confirmed in the Affiliated Hospital of Nantong University from January 2007 to July 2013 were enrolled by retrospective analysis method in this study. According to treatment methods, the patients （ n = 30） were treated by biliary stent combined with 125 I-seed bar implanta- tion as observation group,and the patients （n = 24 ）were treated only by biliary stent implantation as control group. The clinical curative effects of two groups were observed and analyzed respectively. Results The biliary stent and/or 125 I-seed bar were successfully implanted in all patients. Postoperative cholangiography revealed bile duct patency. Operation success rate was 100%. After operation, itchy of skin disappeared;stool turned into yellow;total bilirubin level decreased obviously even down to normal level. There were no massive hemorrhage and failure of liver and kidney functions in perioperative pe- riod. There was no displacement of stent and 125 I- seed bar. The followed up time was 3-18 months, and 8 cases were lost to follow-up by mid-February 2015. The time of bile duct patency after operation in observation group was significantly longer than that in control group [ （ 8.7 ±0. 7 ） months vs （6.2 ± 0.4） months,P 〈 0. 051. The result of survival analysis showed that the survival time in observation group was significantly longer than that in control group [ （ 11.7 ± 0.8 ） months vs （8.6 ±0. 6） months,P 〈 0.05 ]. Conclusion Biliary stent combined with 125 I-seed bar implantations is a more safe, effec- tive and minimally invasive method for the treatment of cholangiocarcinoma with obstructive jaundice.

关 键 词：胆管癌 阻塞性黄疸 胆道支架植入术 125I粒子条植入术 胆道通畅 生存时间 

分 类 号：R735.8[医药卫生—肿瘤]