胆管癌内镜下逆行胰胆管造影支架植入治疗中金属支架与塑料支架的临床疗效比较  

Comparison of clinical efficacy between metal stent and plastic stent in endoscopic retrograde cholangiopancreatography stent implantation for the treatment of cholangiocarcinoma

作　　者：张春芬 王保永 闫一帆 ZHANG Chunfen;WANG Baoyong;YAN Yifan(Department of Gastroenterology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,He’nan,China)

机构地区：[1]郑州大学附属洛阳中心医院消化内科,河南洛阳4710000

出　　处：《癌症进展》2024年第5期516-519,共4页Oncology Progress

基　　金：河南省中青年卫生健康科技创新人才培养项目(YXKC2021023)。

摘　　要：目的比较胆管癌内镜下逆行胰胆管造影(ERCP)支架植入治疗中金属支架与塑料支架的临床疗效。方法根据植入支架材料的不同将80例胆管癌ERCP支架植入治疗患者分为金属组和塑料组,每组40例,金属组患者采用金属支架,塑料组患者采用塑料支架。比较两组患者的黄疸治疗效果、肝功能指标[总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]、并发症发生情况及支架使用情况。结果金属组患者的黄疸治疗总有效率为97.50%,与塑料组患者的95.00%比较,差异无统计学意义(P﹥0.05)。支架植入后2周,两组患者TBIL、DBIL、ALT、AST水平均低于支架植入前,差异均有统计学意义(P﹤0.05),但组间比较,差异均无统计学意义(P﹥0.05)。金属组患者的并发症总发生率为5.00%,与塑料组患者的12.50%比较,差异无统计学意义(P﹥0.05)。金属组患者支架堵塞率、胆管狭窄复发率均低于塑料组,支架通畅时间长于塑料组,支架使用费用高于塑料组,差异均有统计学意义(P﹤0.05)。结论ERCP支架植入治疗胆管癌时,金属支架、塑料支架均可达到良好的黄疸治疗、肝功能改善效果,但金属支架的支架堵塞率、胆管狭窄复发率更低,支架通畅时间更长。Objective To compare the clinical efficacy of metal stent and plastic stent in endoscopic retrograde cholangiopancreatography(ERCP)stent implantation for the treatment of cholangiocarcinoma.Method A total of 80 patients with cholangiocarcinoma receiving ERCP stent implantation therapy were divided into metal group and plastic group based on the different materials used for implantation,with 40 cases in each group.The metal group received metal stent,while the plastic group received plastic stent.The effects of jaundice treatment,liver function indexes[total bilirubin(TBIL),direct bilirubin(DBIL),alanine transaminase(ALT),aspartate transaminase(AST)],incidence of complications and stent use were compared between the two groups.Result The total effective rate of jaundice treatment in the metal group was 97.50%,and there was no statistically significant difference compared to 95.00%in the plastic group(P>0.05).Two weeks after stent implantation,the levels of TBIL,DBIL,ALT,and AST in both groups were lower than those before stent implantation,and the differences were statistically significant(P<0.05),but there were no statistically significant differences between the two groups(P>0.05).The total incidence of complications in the metal group was 5.00%,and there was no statistically significant difference compared to 12.50%in the plastic group(P>0.05).The stent blockage rate and recurrence rate of bile duct stricture in the metal group were lower than those in the plastic group,and the stent patency time was longer than that in the plastic group,the cost of stent was higher than that in the plastic group,and the differences were statistically significant(P<0.05).Conclusion In the treatment of cholangiocarcinoma with ERCP stent implantation,both metal stent and plastic stent can achieve good jaundice treatment effect and liver function improvement.However,the stent blockage rate and recurrence rate of bile duct stricture of metal stents are lower,and the stent patency time is longer.

关 键 词：胆管癌 内镜下逆行胰胆管造影 支架植入 金属支架 塑料支架 

分 类 号：R735.8[医药卫生—肿瘤]