胆道支架植入联合^(125)I粒子腔内照射治疗胰头癌临床疗效分析  

Analysis on clinical efficacy of biliary stent implantation combined with ^(125)I seed intracavitary irradiation in treating pancreatic head cancer

作　　者：钱震 刘会春[1] 庞青 李宗狂[1] 金浩[1] 周磊[1] QIAN Zhen;LIU Huichun;PANG Qing;LI Zongkuang;JIN Hao;ZHOU Lei(Department of Hepatob-iliary Surgery,First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院肝胆外科,安徽蚌埠233004

出　　处：《现代医药卫生》2018年第8期1123-1127,共5页Journal of Modern Medicine & Health

基　　金：安徽省科技攻关基金项目(1501041155)

摘　　要：目的评估经皮胆道支架植入联合125I粒子腔内照射治疗胰头癌引起的恶性梗阻性黄疸的临床疗效。方法回顾性分析2012年1月至2016年12月该院肝胆外科收治的接受经皮胆道支架植入或联合125I粒子腔内照射治疗的88例胰头癌所致的恶性梗阻性黄疸患者的临床资料,并进行定期随访。其中经皮胆道支架植入联合125I粒子腔内照射治疗50例(支架粒子组),单纯支架植入治疗38例(单纯支架组)。比较两组患者治疗前后黄疸水平、肝功能、肿瘤大小、生存时间等差异。结果两组患者术后胆红素水平均明显降低,肝功能均明显改善。但两组患者术后3、6个月胆红素、转氨酶、ALP水平均呈上升趋势,ALB出现下降趋势与支架粒子组比较,单纯支架组患者上升或下降幅度更大,差异均有统计学意义(P<0.05)。支架粒子组患者术后3、6个月肿瘤最大径、最小径均明显低于单纯支架组;术后6、9、12个月支架通畅率均明显高于单纯支架组,差异均有统计学意义(P<0.05)。支架粒子组患者平均生存时间为(11.4±3.2)个月,单纯支架组为(8.6±2.7)个月。患者生存率[18.00%(9/50)]明显高于单纯支架组[5.3%(2/38)],差异有统计学意义(P<0.05)。结论对不宜手术治疗的胰头癌所致的恶性梗阻性黄疸患者,经皮胆道支架植入联合125I粒子腔内照射治疗在降低胆红素水平、改善肝功能、控制肿瘤生长、延长患者生存时间、支架通畅时间等方面均优于单纯经皮胆道支架植入术。Objective To evaluate the clinical efficacy of percutaneous biliary stent implantation combined with 125I seed intracavitary irradiation in the treatment of malignant obstructive jaundice caused by pancreatic head cancer.Methods The clinical data of 88 patients with pancreatic head cancer treated with percutaneous biliary stent implantation or combined with 125I seed intracavitary irradiation in the department of hepatobiliary surgery of this hospital from January 2012 to December 2016 were retrospectively analyzed and performed the regular follow up.Among them,50 cases were treated by percutaneous biliary stent implantation combined with 125I seed intracavitary irradiation(stent-particle group)and 38 cases were treated by simple percutaneous biliary stent implantation(simple stent group).The level of jaundice,liver function,tumor size and survival time before and after therapy were compared between the two groups.Results The postoperative bilirubin level in the two groups was significantly decreased and the liver function was significantly improved.But the bilirubin,transaminase and ALP at postoperative 3,6 months showed the increasing trend,and ALB appeared the decreasing trend,compared with the stent-particle group,the ascensional range or descend range in the simple stent group were greater,the difference was statistically significant(P<0.05).The maximal tumor diameters and minimal tumor diameters at postoperative 3,6 months in the stent-particle group were significantly lower than those in the simple stent group;the stent patency at postoperative 6,9,12 months in the stent-particle group was significantly higher than that in the simple stent group,the difference was statistically significant(P<0.05).The average survival time of the stent-particle group was(11.4±3.2)months and which in the simple stent group was(8.6±2.7)months.The survival rate in the stent-particle group was significantly higher than that in the simple stent group[18.00%(9/50)vs.5.3%(2/38)],the difference was statistically significant(P<0.

关 键 词：胰腺肿瘤/治疗 黄疸 阻塞性/治疗 胆道 支架 碘放射性同位素/治疗应用 

分 类 号：R735.9[医药卫生—肿瘤]