胆道支架植入加化疗灌注治疗恶性胆道梗阻

Stent Implantation combined with local infusion chemotherapy in treatment of malignant biliary tract obstruction

目的评估胆道支架植入结合介入化疗在恶性胆道梗阻病人中的疗效。方法对49例植入胆道支架后同时进行选择性动脉插管化疗的病人,回顾性分析血清总胆红素(TB)和碱性磷酸酶(ALP)的变化,及支架阻塞发生率和存活时间。结果术后2周,血清总胆红素和碱性磷酸酶水平较术前明显下降。在所有49例植入可膨式金属支架病人中,11例(28.2%)发生阻塞,中位阻塞时间为11个月。中位生存时间为12个月,1年生存率为45%,2年生存率为10%。结论对高位恶性胆道梗阻病人,植入胆道支架同时辅以动脉插管化疗是较好的治疗方法。

Objective To assess the effect of interventional therapy for malignant biliary tract obstruction. Methods The clinical data of 49 patients with malignant biliary tract obstruction received stent implantation and selective transcatheter intra-arterial chemotherapy were retrospectively analyzed. Results Serum total bilirubin and alkaline phosphase levels were markedly decreased after the therapy. Self-expanding metal stents were obstructed in 11（28.2%） patients with a median time of 10 months. The median survival time was 12 months. The one-year survival rate was 45%, and the two year survival rate was 10%. Conclusions Biliary duct stening combined with selective arterial chemotherapy is a better therapy for malignant biliary tract obstruction.