胆道^(125)I粒子支架与^(125)I粒子条+胆道支架治疗低位恶性梗阻性黄疸的临床疗效差异  

Comparative analysis of clinical efficacy of biliary iodine-125 seeds stent and iodine-125 seeds strip combined with biliary stent in the treatment of low malignant obstructive jaundice

作　　者：李均彪 魏宁 树成森 吕墩涛 徐浩 LI Junbiao;WEI Ning;SHU Chengsen;LYU Duntao;XU Hao(Gradate School,Xuzhou Medical Univeoeity,Xuzhou 221000,China;Department of Interventional Radiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学研究生学院,江苏徐州221000 [2]徐州医科大学附属医院介入放射科,江苏徐州221000

出　　处：《医学影像学杂志》2022年第8期1328-1333,共6页Journal of Medical Imaging

摘　　要：目的探讨胆道^(125)I粒子支架与^(125)I粒子条+胆道支架治疗低位恶性梗阻性黄疸(MOJ)临床疗效差异。方法选取我院自2017年11月~2021年3月收治的低位MOJ患者65例。其中观察组34例,采用胆道^(125)I粒子支架植入;对照组31例,实行^(125)I粒子条+胆道支架植入。分析比较两组患者手术前后肝功能的变化情况以及支架通畅时间、生存时间、并发症发生等情况。结果两组手术成功率100%。术后患者的症状均有所缓解。与术前相比,两组患者术后3个月内总胆红素(TBIL)、直接胆红素(DBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)明显下降,差异有统计学意义(P<0.05)。两组之间比较无统计学意义。观察组与对照组的平均胆道支架通畅时间分別为(10.6±0.8)和(7.7±0.6)个月,3、6、12个月的累积支架通畅率为94.1%、76.5%、38.7%和90.2%、73.5%、7.0%,平均生存时间为(11.1±0.8)和(9.0±0.6)个月,两组比较差异有统计学意义(P<0.05)。在肿瘤类型分组中,对照组胰腺癌患者的支架中位通畅时间为8.7个月,要高于观察组的5.8个月,观察组胆管癌患者支架中位通畅时间为12.3个月,高于对照组的7.5个月,差异有统计学意义。两组患者术后未出现严重的并发症。结论胆道支架联合^(125)I粒子植入是治疗低位MOJ的有效的治疗方法。对于环绕胆管壁的肿瘤更倾向于采用胆道^(125)I粒子支架植入,对于偏向一侧的肿瘤病灶,^(125)I粒子条+胆道支架植入的手术方式可获得更大收益。Objective To study the difference of clinical efficacy between biliary iodine-125 seeds stent and biliary iodine-125 seeds strip combined with biliary stent in the treatment of low malignant obstructive jaundice(MOJ).Methods A retrospective analysis was performed on 65 patients with low MOJ admitted to our hospital.In the observation group,34 patients were implanted with biliary iodine-125 seeds stent.In the control group,31 patients were implanted with iodine-125 seeds strip combined with biliary stent.The changes of liver function,stent patency time,survival time and complications were analyzed and compared between the two groups before and after surgery.Results The success rate of both groups was 100%and the symptoms of all patients were relieved after surgery.Compared with before surgery,total bilirubin(TBIL),direct bilirubin(DBIL),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)in 2 groups decreased significantly 3 months after surgery,and the difference was statistically significant(P<0.05).The comparison between the two groups was not statistically significant.The average biliary stent patency time in the observation group and the control group was(10.6±0.8)and(7.7±0.6)months,respectively.The stent patency rate at 3,6 and 12 months was 94.1%,76.5%,38.7%and 90.2%,73.5%,7.0%,respectively.The mean survival time was(11.1±0.8)and(9.0±0.6)months,respectively,and the difference between the two groups was statistically significant(P<0.05).Among the tumor types in this study,the median stent patency time of pancreatic cancer patients in the control group was 8.7 months,higher than 5.8 months in the observation group.The median stent patency time of patients with cholangiocarcinoma in the observation group was 12.3 months,which was higher than that in the control group.There was a statistical difference.There were no serious postoperative complications in the two groups.Conclusion Biliary stent combined with iodine-125 seeds implantation is an effective treatment for low MOJ.For tumors surroundin

关 键 词：恶性梗阻性黄疸 胆道支架植入术 ^(125)I粒子 介入性 放射学 

分 类 号：R575.7[医药卫生—消化系统] R815[医药卫生—内科学]