经内镜植入自膨式金属支架治疗结直肠癌性梗阻的安全性与有效性分析

Efficacy and Safety of Endoscopic Implantation of Self-expanding Metal Stent for Colorectal Cancer Obstruction

目的探讨经内镜植入自膨式金属支架治疗结直肠癌性梗阻的安全性与有效性。方法选择收治的结直肠癌性梗阻患者48例,根据治疗方法的不同分为对照组22例与治疗组22例,对照组给予常规经内镜鼻胆管引流术治疗,治疗组给予经内镜植入自膨式金属支架治疗。结果所有患者都一次性完成手术,两组术后14天的总胆红素与直接胆红素含量都明显低于术前(P<0.05),同时术后14天治疗组的总胆红素与直接胆红素含量明显低于对照组(P<0.05)。治疗组术后14天内的急性胰腺炎、出血、胆漏、穿孔等并发症发生情况明显少于对照组(P<0.05)。所有患者术后随访6个月,治疗组随访3个月与6个月的生存率分别为100.0%和95.8%,对照组分别为83.3%和75.0%,治疗组随访3个月与6个月的生存率明显高于对照组(P<0.05)。结论经内镜植入自膨式金属支架治疗结直肠癌性梗阻的手术成功率高,能有效发挥减黄效果,减少术后并发症的发生,从而延长患者的生存时间。

Objective To investigate the efficacy and safety of endoscopic implantation of self-expanding metal stent for colorectal cancer obstruction. Methods 48 cases of colorectal cancer obstruction,depended on the treatment methods,were divided into the control group of 24 patients and the treatment group of 24 patients,the control group were given nasal biliary drainage treatment,and the treatment group received endoscopic implantation self-expanding metal stent treatment. Results All patients completed one-time surgery,The postoperative 14 days total bilirubin and direct bilirubin in the 2 groups were significantly lower than preoperative（ P〈0. 05）,while the postoperative 14 days total bilirubin and direct bilirubin in the treatment group were significantly lower than the control group（ P〈0. 05）. The postoperative 14 days acute pancreatitis,biliary tract infection,bile leakage,perforation and other complications in the treatment group were significantly less than the control group（ P〈0. 05）. All patients were followed up for 6 months,3-and 6-month survival rates in the treatment group were 100. 0% and 95. 8%,which were significantly higher than those of the control group,83. 3% and 75. 0%（ P〈0. 05）. Conclusion Endoscopic implantation selfexpanding metal stent for colorectal cancer obstruction can effectively play jaundice effect,reduce the incidence of postoperative complications,thus prolonging survival time of patients.