数字减影技术引导下经皮胆道金属支架联合碘125粒子条置入治疗恶性胆道梗阻性黄疸的临床效果  

Clinical effect of digital subtracted angiography-guided percutaneous biliary metal stent combined with iodine-125 seed strand implantation in the treatment of malignant biliary obstructive jaundice

作　　者：黄少鹏 宋优文 王维慧 袁福建 HUANG Shaopeng;SONG Youwen;WANG Weihui;YUAN Fujian(Department of Interventional Therapy,Ganzhou Cancer Hospital,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市肿瘤医院介入治疗科,江西赣州341000

出　　处：《当代医学》2024年第25期52-56,共5页Contemporary Medicine

摘　　要：目的探讨数字减影技术(digital subtracted angiography,DSA)引导下经皮胆道金属支架联合碘125粒子条置入治疗恶性胆道梗阻性黄疸的临床效果。方法选取2021年1—12月赣州市肿瘤医院收治的20例恶性胆道梗阻性黄疸患者作为研究对象,按照患者及家属治疗意愿分为观察组(n=11)与对照组(n=9);对照组采用DSA引导下肝内胆管引流术联合经皮胆道金属支架治疗,观察组在上述疗法基础上联合碘125粒子条置入治疗。比较两组支架通畅时间、支架通畅率、总胆红素(total bilirubin,TBIL)水平、TBIL下降率及并发症发生情况。结果观察组支架通畅时间长于对照组,支架通畅率高于对照组,差异有统计学意义(P<0.05)。治疗后15 d、1个月,两组TBIL水平均低于前一时间点,治疗后15 d,观察组TBIL水平低于对照组,差异有统计学意义(P<0.05)。治疗15 d,观察组TBIL下降率高于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。结论DSA引导下经皮胆道金属支架联合碘125粒子条置入治疗恶性胆道梗阻性黄疸可有效改善患者的肝功能,延长支架通畅时间且未明显增加并发症,安全性较高。Objective To investigate the clinical effect of digital subtracted angiography(DSA)-guided percutaneous biliary metal stent combined with iodine-125 seed strand implantation in the treatment of malignant biliary obstructive jaundice.Methods 20 patients with malignant biliary obstructive jaundice admitted to Ganzhou Cancer Hospital from January to December 2021 were selected as the research subjects,they were divided into observation group(n=11)and the control group(n=9)according to the treatment wishes of patients and their families.The control group was treated with DSA-guided percutaneous biliary metal stent combined with percutaneous biliary metal stent,and the observation group was treated with iodine-125 seed strand implantation on the basis of the above treatment.The stent patency time,patency rate,total bilirubin(TBIL)level,decrease rate of TBIL and occurrence of complications were compared between the two groups.Results The stent patency time in the observation group was longer than that in the control group,and the patency rate was higher than that in the control group,the differences were statistically significant(P<0.05).After 15 d and 1 month of treatment,the TBIL level of the two groups were lower than that of the previous time point,and the observation group was lower than that in the control group after 15 d of treatment,and the difference was statistically significant(P<0.05).15 d after treatment,the decrease rate of TBIL in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups.Conclusion DSA-guided percutaneous biliary metal stent combined with iodine-125 seed strand implantation in the treatment of malignant biliary obstructive jaundice can effectively improve liver function and prolong stent patency time without significantly increasing complications,and it has high safety.

关 键 词：数字减影技术 经皮胆道金属支架 碘125粒子条 恶性胆道梗阻性黄疸 支架畅通率 胆红素 

分 类 号：R65[医药卫生—外科学]