胆道支架植入联合胆道外引流治疗恶性胆道梗阻的近中期随访评价  

Early and mid-term follow-up evaluation of biliary stent implantation combined with external biliary drainage in the treatment of malignant biliary obstruction

作　　者：赵建廷 吕昌光 李江 吴琼 Zhao Jianting;Lyu Changguang;Li Jiang;Wu Qiong(Department of Interventional Vasculur,Suhou Municipal Hospital East District,Suzhou Jiangsu Province 215000,China;Department of Vascular Surgery,Sichuan Cancer Hospital,Chengdu Sichuan Province 610042,China)

机构地区：[1]苏州市市立医院东区介入血管科,江苏苏州215000 [2]四川省肿瘤医院血管外科,成都610042

出　　处：《中华普外科手术学杂志（电子版）》2022年第4期454-457,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：2019年四川省卫生健康科研课题(19PJ142)。

摘　　要：目的评价胆道支架植入联合胆道外引流治疗恶性胆道梗阻(MBO)的近中期随访情况。方法回顾性队列研究2015年5月至2018年5月120例MBO患者临床资料,根据治疗方式的不同分为三组,将接受胆道支架植入治疗的40例患者纳入植入组,将接受胆道外引流治疗的40例患者纳入引流组,将接受胆道支架植入联合胆道外引流治疗的40例患者纳入联合组。采用SPSS23.0软件进行数据处理,卡氏(KPS)评分以(x±s)表示,多组间比较采用单因素方差分析;治疗效果采用秩和检验;术后并发症采用χ^(2)检验;采用Long-Rank检验进行生存分析,Kaplan-Meier法绘制生存曲线。P<0.05为差异有统计学意义。结果联合组手术总有效率(52.5%)均高于植入组(20.0%)与引流组(30.0%),P<0.05;联合组患者术后1年2年及3年的KPS评分均高于植入组与引流组(P<0.05);三组患者术后并发症发生率、术后1年、3年生存率相比,差异无统计学意义(P>0.05);联合组术后2年的生存率(58.5%)高于植入组(32.5%)与引流组(22.5%),P<0.05。结论胆道支架植入联合胆道外引流治疗MBO具有较佳的效果,能够提高患者近中期生活质量及生存率,相对安全可靠。Objective To evaluate the follow-up of biliary stent implantation combined with biliary drainage for malignant biliary obstruction(MBO).Methods A retrospective cohort study was conducted on the clinical data of 120 MBO patients from May 2015 to May 2018.According to the different treatment methods,40 patients receiving biliary stent implantation were included in the implantation group,40 patients receiving extemnal biliary drainage were included in the drainage group,and 40 patients receiv ing biliary stent implantation combined with extermal biliary drainage were included in the combined group.SPSS 23.0 software was used for data processing,and KPS score was expressed as(x±s).One-uoay ANOVA analysis of variance was used for comparison between multiple groups.Rank sum lest was used for therapeutic effect.Postoperative complications were tested by χ^(2) test.Log-Rank test was used for survival analysis.and Kaplan-Meier method was used to draw survival curve.P<0.05 was considered statistically significant.Results The total flective rate in combined group(52.5%)was higher than that in implantation group(20.0%)and drainage group(30.0%).P<0.05.The KPS score of the combined group at 1,2 and 3 years after operation was higher than that of the implantation group and the drainage group(P<0.05).There were no significant differences in the incidence of postoperative complications and the 1-year and 3-year survival rate between the 3 groups(P>0.05).The 2-year survival rate of the combined group(58.5%)was higher than that of the implantation group(32.5%)and drainage group(22.5%).P<0.05.Conclusion Biliary stent implantation combined with extermal biliary drainage is flective in the treatment of MBO,which can improve the quality of life and survival rate in the near and medium term.

关 键 词：恶性胆道梗阻 胆道支架植入 胆道外引流 随访研究 

分 类 号：R65[医药卫生—外科学]