光动力疗法联合ERCP治疗恶性胆道肿瘤的临床研究

Clinical study of photodynamic therapy combined with ERCP in the treatment of malignant biliary tract tumors

目的探讨光动力疗法联合经内镜逆行性胰胆管造影(ERCP)在恶性胆道肿瘤治疗中的应用效果。方法随机选取2018年2月至2021年2月江西省宜春市人民医院接收的38例恶性胆管肿瘤患者,随机分为两组,对照组(n=17)采取ERCP下胆管金属支架置入术,观察组(n=21)实施ERCP下胆管金属支架置入术联合光动力疗法治疗,对两组治疗效果进行对比。结果治疗前,两组碱性磷酸酶、总胆红素及γ-谷氨酰转肽酶比较,差异无统计学意义(P>0.05);治疗后,观察组低于对照组,差异有统计学意义(P<0.05);对照组并发症总发生率为29.41%,观察组为4.76%,观察组低于对照组,差异有统计学意义(P<0.05);对照组毒副反应总发生率为41.18%,观察组为9.52%,观察组低于对照组,差异有统计学意义(P<0.05)。结论恶性胆管肿瘤临床治疗过程中结合光动力疗法与ERCP治疗方法,有助于改善患者碱性磷酸酶及总胆红素水平,而且能够尽可能地降低并发症及毒副反应发生率,值得临床进一步应用推广。

Objective To explore the effect of photodynamic therapy combined with endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of malignant biliary tract tumors.Methods A total of 38 patients with malignant bile duct tumors received treatment in Yichun People′s Hospital in Jiangxi Province were from February 2018 to February 2021 randomly divided into the two group control group(n=17)treated with ERCP biliary metal stent implantation and observation group(n=21)treated with ERCP biliary metal stent implantation combined with photodynamic therapy.The therapeutic effects were compared between the two groups.Results There were no significant differences in alkaline phosphatase,total bilirubin andγ-glutamyl transpeptidase before treatment between the two groups(P>0.05).After treatment,the alkaline phosphatase,total bilirubin andγ-glutamyl transpeptidase of the observation group was lower than those of the control group,and the difference was significant(P<0.05).The total incidence rate of complications was 4.76%in the observation group,which was lower than that of 29.41%in the control group,and the difference was significant(P<0.05).The total incidence rate of toxicity was 9.52%in the observation group,which was lower than 41.18%in the control group,and the difference was significant(P<0.05).Conclusion In the clinical treatment of malignant bile duct tumors,combining photodynamic therapy with ERCP is helpful to improve the levels of alkaline phosphatase and total bilirubin,and can reduce the incidence of complications and toxicity as far as possible.It is worthy of further clinical application and promotion.