带膜和无膜金属胆管支架治疗恶性胆梗阻的阻塞情况分析

Analysis on Factors that Cause Covered and Bare Biliary Stent Obstruction for Malignant Biliary Obstruction

目的分析带膜和无膜两种类型自膨式金属胆管支架治疗恶性胆管梗阻的阻塞情况。方法回顾分析2002～2004年间,共有84例中下部恶性胆管梗阻病人接受美国Boston公司wallstent自膨式金属胆管支架治疗。其中,无膜支架组53例,带膜支架组31例。记录随访两组病人支架减黄效果和通畅时间并进行比较,进而分析胆管支架阻塞情况。结果中下部恶性胆管梗阻:无膜金属胆管支架通畅时间平均为135 d,带膜金属胆管支架的通畅时间为平均为332 d,明显优于前者(P<0.01)。结论自膨式金属胆管支架术可解除恶性胆管梗阻,减黄效果明显,带膜支架解除胆管梗阻疗效更佳;带膜金属胆管支架的通畅时间明显优于无膜金属胆管支架。

Objective To analyze the factors that cause biliary stent obstruction.Methods A total of 84 cases of malignant biliary obstruction were divided into group of covered stent（31 cases） and group of bare stent（53 cases） and were treated with expandable metallic biliary stent implantation（wallstent Boston）.The icterus indexes were recorded before and after the operation and records of patency time were compared to analyze the reason that cause biliary stent obstruction.Results Two kinds of stent both had good effect of reducing jaundice.The average patency time of group of covered stent was 332 days.This time was obviously longer than that 135 days of the group of bare stent（P〈0.01）.Conclusion Expandable metallic biliary stent implantation might have good effect to reduce malignant biliary obstruction and jaundice.The patency time of covered stent could be obviously longer than that of bare stent.