单纯胆道支架与支架联合^(125)I粒子条植入治疗恶性梗阻性黄疸:一项回顾性对照研究

Simple biliary stenting versus biliary stenting combined with ^(125)I seed strands implantation for the treatment of malignant obstructive jaundice:a retrospective controlled study

目的评价胆道支架联合^(125)I粒子条植入在恶性梗阻性黄疸(MOJ)患者中的安全性与疗效。方法回顾性分析2015年3月至2020年9月收治的62例MOJ患者,其中27例接受胆道支架联合^(125)I粒子条植入(观察组),35例仅接受单纯胆道支架植入(对照组)。分析两组患者的支架通畅率、不良反应发生率和生存期。结果所有患者手术的技术均获成功,临床有效率观察组为96.3%,对照组为97.1%(P=0.228)。观察组术后Child-Pugh评分下降(1.63±1.11)分,显著优于对照组的(0.8±1.49)分(P=0.019)。观察组的中位支架通畅时间和中位总生存期(mOS)分别为41.3周和44.6周,显著优于对照组的28周和31周(P<0.05)。术后并发症方面,两组差异无统计学意义。结论支架联合碘125粒子条植入对MOJ的治疗安全、有效,值得进一步应用和研究。

Objective To evaluate the safety and efficacy of biliary stenting combined with ^(125)I seed strands implantation for the treatment of malignant obstructive jaundice(MOJ).Methods The clinical data of 62 MOJ patients,who were admitted to hospital between March 2015 and September 2020 to receive treatment,were retrospectively analyzed.Among them,27 patients received biliary stenting combined with ^(125)I seed strands implantation(study group),and 35 patients received simple biliary stenting(control group).The stent patency,incidence of adverse reactions and survival time of both groups were analyzed.Results Technical success was achieved in all patients.The clinical efficacy in the study group and the control group was 96.3%and 97.1%respectively(P=0.228).The postoperative Child-Pugh score in the study group decreased by(1.63±1.11)points,which was prominently better than(0.8±1.49)points in the control group(P=0.019).The median stent patency time and median OS(mOS)in the study group were 41.3 weeks and 44.6 weeks respectively,which were significantly better than 28.0 weeks and 31.0 weeks respectively in the control group(P<0.05).No statistically significant difference in postoperative complications existed between the two groups.Conclusion For the treatment of MOJ,biliary stenting combined with;I seed strands implantation is clinically safe and effective.Therefore,this technique is worthy of further application and research.