^(125)I粒子支架治疗恶性胆管梗阻的临床疗效

Percutaneous ^(125)I seed-loaded stent implantation for the treatment of malignant obstructive jaundice:analysis of clinical efficacy

目的探讨DSA透视下行经皮经肝125I粒子支架植入治疗恶性胆管梗阻的临床疗效。方法26例恶性胆管梗阻患者,11例接受125I粒子支架治疗,15例接受普通金属支架植入治疗(对照组),统计、比较2组患者术前、术后生化指标变化、支架通畅率及生存期。结果手术成功率100%,术后1个月患者血清胆红素、丙氨酸转氨酶及碱性磷酸酶均明显降低(P<0.05)。术后6个月、1年125I粒子支架通畅率明显优于普通支架(P<0.05)。普通支架组患者中位生存期3.8个月,平均生存期4.3个月,粒子支架组中位生存期7.1个月,平均生存期9.1个月,粒子支架组优于普通支架组(P<0.05)。2组均无严重并发症发生。结论 125I粒子支架植入治疗恶性胆管梗阻能明显提高支架通畅率,延长患者生存期。

Objective To investigate the clinical efficacy of percutaneous implantation of biliary stent loaded with125 I seeds in treating malignant obstructive jaundice. Methods A total of 26 patients with malignant biliary obstruction were enrolled in this study. Of the 26 cases, percutaneous implantation of biliary stent carrying125 I seeds was performed in 11（study group） and percutaneous implantation of conventional metallic biliary stent was employed in 15（control group）. The preoperative and postoperative biochemical indexes were determined, and their changes, the stent patency rate as well as the survival time were calculated. The results were compared between the two groups. Results Technical success rate was 100%.One month after the treatment, the serum bilirubin, alanine aminotransferase and alkaline phosphatase levels were significantly decreased（P 0.05）. The 6-month, one-year stent patency rates in the study group were significantly higher than those in the control group（P 0.05）. The median survival time and the mean survival time were 3.8 months and 4.3 months respectively in the control group, and 7.1 months and 9.1months respectively in the study group（P 0.05）. No serious complications occurred in both groups.Conclusion For the treatment of malignant obstructive jaundice, percutaneous implantation of biliary stent carrying125 I seeds can significantly improve the stent patency rate and prolong the survival time.