胆道 125 I粒子支架置入术在不可切除肝外胆管癌中的疗效分析  

Analysis of the therapeutic effect of 125 I particle stent placement in unresectable extrahepatic cholangiocarcinoma

作　　者：王学俊[1] 朱军[1] 祁志 潘杰 黄锐 WANG Xuejun;ZHU Jun;QI Zhi;PAN Jie;HUANG Rui(Interventional Radiography,Yancheng Third People's Hospital,Yancheng 224000,China)

机构地区：[1]盐城市第三人民医院介入放射科,江苏盐城224000

出　　处：《中国肿瘤外科杂志》2024年第3期261-265,共5页Chinese Journal of Surgical Oncology

基　　金：江苏省自然科学基金(BK20191077)。

摘　　要：目的分析胆道125 I粒子支架置入术在不可切除肝外胆管癌中的疗效。方法回顾性分析2015年1月至2023年1月盐城市第三人民医院收治的肝外胆管癌患者64例。根据治疗方法分为观察组34例和对照组30例,对照组采用裸金属胆道支架治疗,观察组采用125 I粒子胆道支架置入术治疗,记录两组的手术时间。治疗1个月后,比较两组患者的血清胆红素、癌胚抗原(CEA)、糖类抗原(CA)19-9、碱性磷酸酶、γ-谷氨酰转肽酶、丙氨酸转氨酶、并发症及不良反应。随访12个月,记录支架通畅时间、中位总生存期(OS)。结果观察组和对照组的手术时间分别为(32.61±10.91)min、(21.09±8.37)min,观察组手术时间长于对照组,差异有统计学意义(P<0.05)。治疗后,观察组与对照组患者的胆红素水平分别为(20.56±4.02)μmol/L、(27.85±4.16)μmol/L,与治疗前比较,两组胆红素水平均降低,观察组低于对照组(P<0.05)。治疗后,两组患者的CEA、CA19-9水平均降低,观察组低于对照组(P<0.05)。治疗后,两组患者的碱性磷酸酶、γ-谷氨酰转肽酶、丙氨酸转氨酶水平均降低,观察组低于对照组(P<0.05)。观察组和对照组的不良反应发生率分别为14.71%(5/34)、13.33%(4/30),差异无统计学意义(P>0.05)。观察组和对照组的支架通畅时间分别为(10.37±1.06)个月、(6.74±0.81)个月,两组比较差异有统计学意义(P<0.05)。观察组中位OS为12个月,对照组中位OS为9个月。观察组OS高于对照组(P<0.05)。结论125 I粒子支架置入治疗不可切除肝外胆管癌,有助于改善胆道梗阻,延长支架通畅时间,抑制肿瘤标志物表达,安全性良好。Objective To explore the therapeutic effect of 125 I particle stent placement in unresectable extrahepatic cholangiocarcinoma.Methods Sixty-four patients with extrahepatic cholangiocarcinoma admitted to Yancheng Third People's Hospital from January 2015 to January 2023 were retrospectively analyzed.According to the treatment method,there were 34 cases in the observation group and 30 cases in the control group.The control group was treated with bare metal biliary stent,while the observation group was treated with 125 I particle biliary stent implantation.The surgical time of both groups was recorded.After one month of treatment,the levels of bilirubin,carcinoembryonic antigen(CEA),carbohydrate antigen(CA)19-9,alkaline phosphatase,γglutamyl transpeptidase,alanine aminotransferase,complications and adverse reactions were compared.Stent patency time and median overall survival(OS)were recorded during 12 months of follow-up.Results The surgical time of the observation group and the control group were(32.61±10.91)minutes and(21.09±8.37)minutes,respectively.The surgical time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the bilirubin levels in the observation group and the control group were(20.56±4.02)μmol/L and(27.85±4.16)μmol/L,respectively.Compared with the levels before treatment,the bilirubin levels in both groups decreased,and the observation group was lower than the control group(P<0.05).After treatment,the CEA and CA19-9 levels in both groups decreased on average,and the observation group was lower than the control group(P<0.05).After treatment,the alkaline phosphatase levels in both groupsγ-The levels of glutamyltransferase and alanine aminotransferase decreased,and the observation group was lower than the control group(P<0.05).The incidence of adverse reactions in the observation group and the control group were 14.71%(5 cases/34 cases)and 13.33%(4 cases/30 cases),respectively,with no statistically significa

关 键 词：胆管癌 胆道支架 碘-125标志物 生存预后 

分 类 号：R735.8[医药卫生—肿瘤]