摘要
目的评估经皮胆道植入支架联合125I粒子条在治疗恶性梗阻性黄疸中的安全性、有效性及临床应用价值。方法回顾性分析2015年11月至2018年2月在收治的142例恶性梗阻性黄疸患者,其中50例患者(实验组)接受裸支架联合125I粒子条植入,92例患者(对照组)仅进行了裸支架的植入。观察两组患者支架通畅率、生存期及术后并发症。结果实验组支架通畅期中位数为226 d,生存期中位数为194 d,对照组支架通畅期中位数为86 d,生存期中位数为117 d,实验组优于对照组(P<0.05)。在实验组中,平均15颗125I粒子(8~22)作为粒子条联合裸支架同时植入胆管内。与手术前的实验室指标相比,两组术后1周肝功能包括总胆红素,直接胆红素,丙氨酸转氨酶显著降低,且两组间术后1周肝功能变化无统计学差异(P>0.05),严重并发症仅发生在对照组的1例患者。结论金属支架联合125I粒子条植入对恶性梗阻性黄疸的治疗有效、安全,可以提高支架通畅时间和患者生存期,值得进一步临床研究。
Objective To evaluate the safety,efficacy and clinical application value of percutaneous transhepatic biliary stenting with 125I seed strand implantation in the treatment of malignant obstructive jaundice(MOJ).Methods The clinical data of 142 patients with MOJ,who were admitted to authors’department during the period from November 2015 to February 2018 to receive treatment,were retrospectively analyzed.Of the 142 patients,bare stent combined with 125I seed strand implantation was performed in 50(study group)and simple bare stent implantation was adopted in 92(control group).The stent patency,survival time and postoperative complications of the two groups were recorded.Results In the study group the median time of stent patency was 226 days and the median survival time was 194 days,which in the control group were 86 days and 117 days respectively,the results in the study group were significantly better than those in the control group(P<0.05).In the study group,seed strand containing 8-22125I seeds(average of 15125I seeds)and bare stent were simultaneously implanted into the biliary duct.One week after treatment,the liver function examination showed that the levels of total bilirubin,direct bilirubin and alanine aminotransferase were remarkably decreased when compared with the preoperative ones,but no statistically significant differences in the changes of liver function existed between the two groups(P>0.05).Severe complication occurred only in one patient of the control group.Conclusion For the treatment of MOJ,the combination use of bare stent and 125I seed strand is effective and safe.It can improve stent patency time and patient survival time.Therefore,this therapy is worthy of further clinical study.
作者
徐红豆
周卫忠
刘圣
周春高
夏金国
张卫
施海彬
XU Hongdou;ZHOU Weizhong;LIU Sheng;ZHOU Chungao;XIA Jinguo;ZHANG Wei;SHI Haibin(Department of Interventional Radiology,First Affiliated Hospital of Nanjing Medical University,Nanjing,Jangsu Province 210029,China)
出处
《介入放射学杂志》
CSCD
北大核心
2020年第1期83-88,共6页
Journal of Interventional Radiology
