胆道支架置入术联合125I条以及肝动脉化疗栓塞术治疗恶性胆道梗阻  

Biliary stenting combined with 125I seed strip implantation and hepatic artery chemoembolization for malignant biliary obstruction

作　　者：颜波 吕朋华 王福安 王书祥 孙陵 YAN Bo;LV Penghua;WANG Fuan;WANG Shuxiang;SUN Ling(Department of Interventional Radiology,North Jiangsu People's Hospital,Yangzhou,Jiangsu Province 225001,China)

机构地区：[1]苏北人民医院介入科,江苏扬州225001

出　　处：《介入放射学杂志》2022年第11期1085-1088,共4页Journal of Interventional Radiology

摘　　要：目的探讨胆道支架置入术联合125I条内照射以及肝动脉化疗栓塞术治疗恶性胆道梗阻的临床疗效。方法回顾性分析2017年6月至2020年9月江苏省苏北人民医院治疗恶性胆道梗阻的患者共35例。所有患者首先在数字减影血管造影下经皮肝胆管引流(PTCD),12例患者行胆道支架植入治疗(对照组),23例患者接受经皮胆道支架置入术联合125I条以及肝动脉化疗栓塞术治疗(观察组)。结果35例患者手术成功率为100%,术后两组均未发生与手术相关的严重并发症。观察组和对照组血清TBil术后4周较术前明显下降,差异有统计学意义(P<0.05)。术后,观察组胆道通畅时间为(6.50±0.34)个月,长于对照组的(2.40±0.17)个月,差异有统计学意义(P<0.05);观察组与对照组患者中位生存时间分别为(7.20±0.48)个月和(2.40±0.17)个月,差异有统计学意义(P<0.05)。结论胆道支架置入术联合125I条以及肝动脉化疗栓塞术治疗恶性胆道梗阻临床效果显著,能抑制肿瘤生长,延长支架开放时间及患者生存时间。Objective To investigate the clinical effects of biliary stenting combined with125I seed strip internal radiation and hepatic artery chemoembolization in treating patients with malignant biliary obstruction.Methods The clinical data of 35 patients with malignant biliary obstruction,who were admitted to the North Jiangsu People’s Hospital of China between June 2017 and September 2020 to receive treatment,were retrospectively analyzed.Under DSA guidance,percutaneous transhepatic cholangial drainage(PTCD)was performed in all patients,which was followed by percutaneous biliary stent implantation(n=12,control group)or by percutaneous biliary stent implantation combined with125I seed strip implantation and hepatic artery chemoembolization(n=23,observation group).Results Technical success rate was 100%.No postoperative operation-related serious complications occurred in both groups.In both groups,the postoperative 4-week serum total bilirubin level was remarkably lower than the preoperative one,the difference was statistically significant(P<0.05).After treatment,the mean biliary unobstructed time in the observation group was(6.50±0.34)months,which was longer than(2.40±0.17)months in the control group,the difference between the two groups was statistically significant(P<0.05).The mean survival time of the observation group and the control group was(7.20±0.48)months and(2.40±0.17)months respectively,the difference between the two groups was statistically significant(P<0.05).Conclusion For the treatment of malignant biliary obstruction,percutaneous biliary stent implantation combined with125I seed strip implantation and hepatic artery chemoembolization has excellent clinical effect,it can inhibit tumor growth,prolong stent unobstructed time and patient’s survival time.(J Intervent Radiol,2022,31:1085-1088)

关 键 词：胆道支架 125I粒子 肝动脉化疗栓塞术 恶性胆道梗阻 

分 类 号：R573.2[医药卫生—消化系统]