普通金属支架与125I粒子支架植入治疗恶性梗阻性黄疸的疗效分析  

Effect analysis of malignant obstructive jaundice treated by common metal stent and 125 I seed stent

作　　者：周可 宁波[2] 王行 ZHOU Ke;NING Bo;WANG Xing(Department of Oncology,Chongqing Sixth People′s Hospital,Chongqing 400060,China;Department of Gastroenterology,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆市第六人民医院肿瘤科,重庆400060 [2]重庆医科大学第二附属医院消化内科,重庆400010

出　　处：《检验医学与临床》2020年第13期1826-1829,共4页Laboratory Medicine and Clinic

摘　　要：目的比较普通金属支架与125I粒子支架植入治疗恶性梗阻性黄疸的临床疗效。方法选择31例恶性梗阻性黄疸患者为研究对象,其中16例采用普通金属支架共21枚进行治疗(普通支架组),15例采用125I粒子支架共16枚进行治疗(125I粒子支架组),同时给予吉西他滨、顺铂等化疗药物治疗。比较两组患者术前与术后血清总胆红素(TBIL)、血清肿瘤标志物糖类抗原199(CA199)的水平、支架通畅率及生存率。结果 31例患者均手术成功。术前,两组TBIL水平比较,差异无统计学意义(P>0.05);术后2周和4周时,125I粒子支架组血清TBIL均明显低于普通支架组,差异有统计学意义(P<0.05)。125I粒子支架组血清肿瘤标志物CA199在术后1个月和3个月的水平均低于术前(P<0.05),两组术后CA199水平比较,差异有统计学意义(P<0.05)。两组患者术后6个月的支架通畅率比较,差异有统计学意义(P<0.05);125I粒子支架组术后12个月的通畅率及生存率均明显高于普通支架组(P<0.05)。结论 125I粒子支架植入治疗恶性梗阻性黄疸较普通金属支架植入治疗在黄疸消退、抑制肿瘤生长、改善症状及延长生存时间等方面明显具有一定优势,值得临床推广应用。Objective To evaluate the difference of clinical efficacy between the implantation of common metal stent and 125 I seed stent in the treatment of malignant obstructive jaundice.Methods A total of 31 patients with malignant obstructive jaundice were treated,including 16 patients implanted 21 metallic biliary stents(common metal stent group),and other 15 patients implanted 16125 I seed stents(125 I seed stent group).And all the patients were treated with gemcitabine,cisplatin and other chemotherapy drugs.Before and after the treatment,levels of total bilirubin(TBIL),carbohydrate antigen 199(CA199),stent patency rate and survival rate were compared between the two groups.Results All the 31 patients were successfully operated.Before treatment,levels of TBIL between the two groups had no statistical difference(P>0.05).Two weeks and four weeks after treatment,level of TBIL of 125 I seed stent group was significantly lower than that of common metal stent group(P<0.05).One months and three months after the treatment,levels of CA199 of 125 I seed stent group were significantly lower than before the treatment(P<0.05).And levels of CA199 between the two groups had statistical difference(P<0.05).The patency rates at the six months after the operation of common metal stent group and the 125 I seed stent group had shown significant difference(P<0.05).The patency rates and survival rates at 12 months after treatment of 125 I seed stent group were significantly higher than that of common metal stent group(P<0.05).Conclusion The treatment of 125 I seed stent in malignant obstructive jaundice has obvious effect in jaundice regression,inhibition of tumor growth,improvement of symptoms and extension of survival time,and is worthy of clinical promotion and application.

关 键 词：胆道支架 125I粒子支架 恶性梗阻性黄疸 

分 类 号：R735.8[医药卫生—肿瘤]