792例恶性胆道梗阻内支架引流随访研究

A survey research to 792 patients with malignant biliary obstruction after innerstents drainage procedure

目的评价支架置入治疗恶性胆道梗阻的临床效果及价值。方法792例恶性胆管梗阻中,高位胆管梗阻398例。中低位胆管梗阻394例,采用单点位单支架及双点位双通道双支架置入,单点位单通道双支架置入或单支架置入配合外引流的治疗方法。测定术前、术后血清总胆红素水平并进行t检验,差异显著(P<0.05),且均以直接胆红素下降为主。生存满6个月578例,73%(578/792);生存6个月以上505例,64%(505/792);生存一年或一年以上329例,45%(329/792)。结论①单点位单支架及双点位双通道双支架,单点位单通道双支架置入或单支架配合外引流,均能实现梗阻胆管全面充分内引流。②支架置入联合抗肿瘤治疗可提高病人生存率和降低支架再梗阻的发生。

Objective： To judge the clinical effect of stents for treatment of malignant biliary obstruction. Methods ： In 792 patients with malignant biliary obstruction, there were 398 with perihilar biliary obstruction, and 394 with middle and lower biliary obstruction. Single stent,single puncture dot on outhepatic biliary obstruction ,and double stents,double puncture dot,double tract or double stents,single tract,single puncture dot on hepatic hilar biliary obstruction Results ： There were significant differences in serum total bilirubin level of preoperatively and postoperatively （p〈0.05） for 792cases.The survival rate of 6 months was 73%（573/792）. The survival rate of over 6 months was 64%（505/792）. The survival rate of 12 months or over 12 months was 45%（329/792）. Conclusion C1）.It is effective to achieve entire internal drainage by single stent,single puncture dot on outhepatic biliary obstruction ,and double stents,double puncture dot,double tract or double stents,single tract, single puncture dot on hepatic hilar biliary obstruction. It has an evidently clinical value. （2）.Stents combined with antitumor treatment can increase the survival rate and decrease the rate of stent reobstructions.