高位恶性胆道梗阻多支架植入术的临床应用及疗效分析

Clinical application and therapeutic efficacy of multi-stent placement for upper malignant biliary obstruction

目的 分析评价胆道多支架植入术对肝门部高位恶性胆道梗阻的临床疗效及应用价值。方法 58例肝门部胆道梗阻病人,单支架植入26例,多支架植入32 例。结果 单支架、多支架植入成功率分别为100%和93. 75%(P>0 .05);术后胆红素下降率分别为64 .12%和75 .54%(P<0 05);单支架和多支架6 个月、12 个月、18 个月的生存率分别为78. 82%、38 .43%、8 .87%和88 .17%、45. 16%、19. 35%(P<0 .05);并发症发生率分别为26 .93%和25. 00%(P>0. 05)。结论 肝门部胆道狭窄多支架植入同单支架植入比较能更有效地解除黄疸,延长生存期,且成功率及并发症同单支架术无显著性差异,是值得临床推广应用的介入治疗技术。

Objective To investigate the therapeutic efficacy and clinical value of multi-stent placement (MSP) for malignant biliary obstruction (MBO). Methods For 58 patients with MBO, single stent placement was performed in 26 (group A) and MSP in 32 (group B). Results The successful rate of single stent placement and MSP was 100% and 93.75%, respectively (P>0.05). The decreasing rate of serum level of total bilirubin was 64.12% vs 75.54% (P<0.05), 0.5-, 1- and 1.5-year survival rates 78.82%, 38.43%, 8.87% vs 88.17%, 45.16%, 19.35% (P<0.05) and occurring rate of complications 26.93% vs 25% (P>0.05) in group A and group B, respectively. Conclusions Compared with single stent placement, MSP can better palliate obstruction of the upper bile duct and result in longer survival time. There is no significant difference in successful rate and occurring rate of complications between the 2 methods. Therefore, MSP is a valuable interventional technique for clinical application.