胆道支架置入联合介入化疗治疗恶性胆道梗阻的临床疗效分析

Clinical curative effect analysis of the treatment of malignant biliary obstruction by stent implantation combined with interventional chemotherapy

目的探讨胆道支架置入联合介入化疗技术治疗恶性胆道梗阻的临床疗效和价值。方法对比分析胆道支架置入联合介入化疗组(C组)、单纯胆道支架置入组(B组)及保守治疗组(A组)患者间的术前、术后肝功能改变,并发症发生率,支架通畅率及远期生存时间。结果共纳入病例58例,同A组相比,B、C组肝功能得到明显改善,差异有统计学意义(P<0.05);B、C两组与操作有关的并发症发生率为19.1%(9/47),均经保守治疗后恢复,无严重并发症发生;B组术后第3、6、12月时支架通畅率分别为77.8%(14/18)、38.9%(7/18)、11.1%(2/18);C组术后第3、6、12月支架通畅率分别为85%(17/20)、55%(11/20)、30%(6/20);A组、B组及C组的中位生存期分别为2.4、8.2及12.9个月。结论胆道支架置入联合介入化疗技术治疗恶性胆道梗阻切实可行,安全有效,能显著改善肝功能,延长支架通畅时间,延长患者远期生存时间。

Objective To explore the therapeutic effect and value of combined biliary stenting and interventional chemotherapy for the treatment of malignant biliary obstruction. Method To retrospectively review and analyze the improvement of liver function, complication rate, stent patency rate and survival time among C group （biliary stenting ＋ interventional chemotherapy）, B group （ bili- ary stenting only） and A group （conservative treatment）. Result A total of 58 cases were included in this study. Compared to A group, liver function of patients was obviously got better in B group and C group （ P 〈 0. 05 ）. The operate-related complication rate was about 19.1% （9/47） and all of the complications were controlled effectively by conservative treatment in both B and C group. The stent patency rate of postoperative 3month, 6 month and 12 month were 77.8% （14/18）, 38.9% （7/18） and 11.1% （2/18） in B group, respectively. And 85% （17/20） ,55% （11/20） ,30% （6/20） in C group. The median survival time of patients in A, B and C group were 2.4, 8. 2 and 12.9 months, respectively. Conclusions These results suggest that it is feasibly, effectively and safely to treat malignant biliary obstruction by stent implantation combined with interventional chemotherapy for the treatment of.