^(125)I粒子条联合胆道支架植入治疗恶性梗阻性黄疸22例疗效分析

^(125)I seed-strip combined with biliary stent implantation for malignant obstructive jaundice: clinical analysis of 22 cases

目的研究和探讨125I粒子条联合胆道支架植入治疗恶性梗阻性黄疸的临床疗效。方法2011年6月—2013年9月收治恶性梗阻性黄疸患者40例。行胆道支架植入术治疗患者18例,为对照组;采用125I粒子条联合胆道支架植入患者22例,为观察组。两组均采用经皮肝穿刺胆道引流(PTCD)并胆道支架植入。结果观察组与对照组的平均胆道开通时间分别为(8.7±0.7)和(6.2±0.4)个月,两组比较差异有统计学意义(P<0.05)。观察组与对照组术后平均生存时间分别为(11.4±0.8)和(8.7±0.5)个月,生存时间的差异有统计学意义(P<0.05)。术后近期疗效及并发症两组之间的比较无明显差异(P>0.05),但是远期疗效有显著差异(P<0.05)。结论与对照组相比,观察组的术后生存时间及胆道开通时间明显延长,对于125I粒子条联合支架治疗恶性梗阻性黄疸值得进一步临床研究。

Objective To evaluate the clinical efficacy of125 I seed-strip combined with biliary stent implantation in treating malignant obstructive jaundice. Methods During the period from June 2011 to October 2013, a total of 40 patients with malignant obstructive jaundice were admitted to authors ＇ hospital.Biliary stent implantation was employed in 18 patients（control group） and125 I seed-strip combined with biliary stent implantation was carried out in 22 patients（study group）. Percutaneous transhepatic cholangial drainage（PTCD） was performed in all patients of both groups. Results The mean biliary patency time of the study group and the control group was（8.7 ± 0.7） months and（6.2 ± 0.4） months respectively, and the difference between the two groups was statistically significant（P 0.05）. The mean survival time of the study group and the control group was（11.4 ± 0.8） months and（8.7 ± 0.5） months respectively, and the difference between the two groups was statistically significant（P 0.05）. No statistically significant difference in short-term efficacy and incidence of complications existed between the two groups（P 0.05）, although significant difference in long-term efficacy existed between the two groups（P 0.05）. Conclusion The survival time and the biliary patency time in the study group were obviously longer than those in the control group. Further clinical study on the prolongation of biliary patency time for malignant obstructive jaundice is needed.