可膨式金属胆道支架解除恶性胆管梗阻的中长期疗效

MEDIUM AND LONG TERM RESULTS OF SELF EXPANDING METAL STENT FOR MALIGNANT BILE DUCT OBSTRUCTION

为总结经内镜放置可膨式金属胆道支架（ＥＭＢＥ）的中远期疗效，回顾了７６例恶性胆管梗阻接受ＥＭＢＥ治疗患者的资料，并与同期５３例次放置普通塑料支架的疗效进行对比。结果前者操作成功率９３．８％，与操作有关的并发症发生率６．６％，黄疸消除率为８７．０％，金属支架的平均通畅期为３１０天，明显高于塑料支架的８５天（Ｐ＜０．０１），患者平均存活期为２１０天。随访患者中有１６例（３４．８％）发生支架阻塞，平均发生时间１８５．５天。结果表明可膨式金属胆道支架的平均通畅性能显著优于普通塑料支架，可持久有效解除恶性肿瘤所致的肝外胆管梗阻。

The records of patients with malignant biliary obstruction treatd with endoscopic (self expanding)metal biliary endoprothesis (EMBE, n=76) versus conventional polyethylene stent (n=53) were compared to evaluate the medium and long term effects. Results disclosed that with the former successful implantation was achieved in 93.8%;complication due to procedure limited to 6.6%;jaundice diminished in 87.0%;stent patency kept for 310 days in average (versus 85 days for the latter,P<0 01);patient survived for an average of 210 days;stent occlusion ensued in 34.8% (n=16) on the 185.5 days. Conclusively the self expanding metal stent maintained its patency better and longer than that of polyethylene to palliate biliary obstruction. The mastery of indication seems most essential.