胆道支架联合125I粒子置入与姑息性手术治疗晚期胆管癌的疗效比较  

Comparison of therapeutic effect of biliary stent combined with 125I particle implantation and palliative surgery in the treatment of advanced cholangiocarcinoma

作　　者：周磊[1] 庞青 王勇[1] 满忠然[1] 金浩[1] 谈燚[1] 刘会春[1] ZHOU Lei;PANG Qing;WANG Yong;MAN Zhong-ran;JIN Hao;TAN Yi;LIU Hui-chun(Department of Hepatobiliary Surgery,The 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：《蚌埠医学院学报》2020年第10期1317-1321,共5页Journal of Bengbu Medical College

基　　金：安徽省高校自然科学研究重点项目(KJ2019A0360)。

摘　　要：目的:比较自膨式金属支架联合导管载入式125I粒子(SEMS-CL-125I)与姑息性手术(PS)治疗晚期肝外胆管癌(EHCC)的疗效。方法:选择SEMS-CL-125I(SEMS-CL-125I组,n=67)或PS(PS组,n=34)治疗的晚期EHCC病人,比较2组术后并发症、住院时间、住院费用和总体生存率(OS)的差异。结果:与术前相比,2组病人术后1、3、6个月血清TBIL、ALT、AST水平均降低,而ALB均升高(P<0.05)。SEMS-CL-125I组术后1个月ALB水平显著高于PS组(P<0.05)。2组术后总体并发症差异无统计学意义(P>0.05)。与PS组相比,SEMS-CL-125I组病人的住院时间明显缩短,住院费用明显减少(P<0.01),OS显著改善(P<0.05)。术前TBIL、CA19-9、ALB和治疗方法是与术后OS相关的主要因素。结论:对于晚期EHCC病人,与PS相比,SEMS-CL-125I显著缩短了住院时间,降低了住院费用,延长了生存时间,值得临床推广和应用。Objective:To compare the efficacy of self-expanding metal stent combined with catheter loaded 125I particle(SEMS-CL-125I)and palliative surgery(PS)in the treatment of advanced extrahepatic cholangiocarcinoma(EHCC).Methods:Patients with advanced EHCC treated with SEMS-CL-125I(SEMS-CL-125I group,n=67)or PS(PS group,n 34)were selected.The postoperative complications,hospitalization time,hospitalization expenses and overall survival rate(OS)between the two groups were compared.Results:Compared with that before operation,the levels of TBIL,ALT and AST in the two groups decreased at 1,3 and 6 months after operation,while ALB increased(P<0.05).The level of ALB in SEMS-CL-125I group was significantly higher than that in PS group at 1 month after operation(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).Compared with PS group,The hospitalization time,hospitalization expenses and OS in SEMS-CL-125I group were significantly shorter than those in PS group(P<0.01),and OS was significantly improved(P<0.05).Preoperative TBIL,CA19-9,ALB and treatment method were the main factors related to postoperative OS.Conclusions:Compared with PS,SEMS-CL-125I significantly shortens the hospitalization time,reduces the hospitalization expenses and prolongs the survival time of patients with advanced EHCC,which is worthy of clinical promotion and application.

关 键 词：肝外胆管癌 自膨式金属支架 导管载入式125I粒子 姑息性手术 

分 类 号：R[医药卫生]