内镜下放置不同胆道支架治疗恶性梗阻的疗效比较  

Comparison of the efficacy of endoscopic placement of biliary stent in treatment of malignant biliary obstruction

作　　者：杨璐[1,2] 聂占国[2] 雷婷[2] 热合曼[2] 游云[2] 张新[2] 刘国伟[2] 代忠明[2] 

机构地区：[1]新疆石河子大学医学院,新疆石河子832000 [2]兰州军区乌鲁木齐总医院消化内科

出　　处：《西北国防医学杂志》2015年第12期778-781,共4页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的：探讨内镜下逆行胰胆管造影（endoscopic retrograde cholangio pancreatography,ERCP）放置不同胆道支架治疗胆道恶性梗阻的疗效。方法：选取我院2007-01～2013-06行内镜下支架置入395例胆道恶性梗阻患者,按置入支架不同分为单塑料支架组、双塑料支架组、金属支架组,观察各组的成功率、引流效果、早期并发症发病率及支架通畅时间。结果：单塑料支架、金属支架组成功率显著高于双塑料支架组（P均〈0.05）,金属支架组与单塑料支架组差异无统计学意义（P〉0.05）。3组术后3d的肝功能分别与术前相比均显著好转（P均〈0.05）。单塑料支架组的早期并发症发生率高于双塑料支架组和金属支架组（P均〈0.05）,金属支架和双塑料支架组间无显著差异（P〉0.05）。双塑料支架组的通畅时间明显长于单塑料支架组,金属支架组的支架通畅时间明显长于双塑料支架组（P均〈0.05）。结论：内镜下留置胆道支架能有效缓解胆道梗阻症状;金属支架通畅时间明显长于塑料支架,且并发症发生率低于塑料支架;对于预计生存期较长的患者尽量选择金属支架。Objective：To explore the clinical effectiveness of endoscopic placement of biliary stent in treatment of malignant biliary obstruction.Methods：From January 2007 to June 2013,395 patients in our hospital treated with endoscopic biliary stenting were enrolled.According to the different stent placement,patients were divided into single plastic stent group,double plastic stent group and metallic stent group.The success rate,drainage outcomes,early complications,stent patency and survival were compared.Results：The success rates of single plastic stent group,metallic stent group were significantly higher than that of the double plastic stent group（P〈0.05）,the difference was not statistically significant between metallic stent group and single plastic stent group（P〉0.05）.The liver function was significantly improved compared with that preoperative（P〈0.05）.The rate of early complication of the single plastic stent group was significantly higher than that in double stent group and metallic stent group（P〈0.05）,but there was no significant difference between metallic stent group and double plastic stent group（P〉0.05）.The stent patency time in the double plastic stent group was significantly longer than that in the single plastic stent group,the metallic stent group was significantly longer than that in the double plastic stent group（P〈0.05）.Conclusion：Endoscopic placement biliary stent can effectively alleviate the clinical symptoms of obstructive jaundice.The stent patency time in the metallic stent group is significantly longer than that of the plastic stent group,and the rate of complication is lower than that of stent group.Therefore,metallic stents should be chosen for the more life expectancy patients.

关 键 词：胆道梗阻 经内镜逆行胰胆管造影 胆道支架 塑料支架 金属支架 

分 类 号：R657.4[医药卫生—外科学]