TACE配合125I粒子支架置入治疗肝门部胆管癌效果及对患者生存时间的影响

Effects of TACE combined with 125I particle stent implantation in the treatment of hilar cholangiocarcinoma and its influence on survival time of patients

目的:探究经动脉导管化疗栓塞术(TACE)配合;I粒子支架置入治疗肝门部胆管癌效果及对患者生存时间的影响。方法:回顾性分析我院行TACE治疗(对照组)和行TACE配合;I粒子支架置入治疗(观察组)的肝门部胆管癌患者各34例临床资料。比较两组术前(T0)、术后2个月(T1)、术后4个月(T2)、术后6个月(T3)肿瘤直径和血清总胆红素(TBIL)水平差异,并记录两组临床疗效及并发症发生情况,采用Kaplan-Meier法绘制两组生存曲线,分析其术后24个月生存情况。结果:观察组T1、T2、T3肿瘤直径均低于T0,且T3肿瘤直径低于T0;对照组T3肿瘤直径低于T0;两组T0、T1肿瘤直径比较,差异无统计学意义;T2、T3时,观察组肿瘤直径明显低于对照组。两组T1、T2、T3血清TBIL水平均低于T0,且T2、T3血清TBIL水平低于T1;T0、T2、T3时,两组血清TBIL水平比较,差异无统计学意义;而T1时,观察组血清TBIL水平高于对照组。观察组临床疗效明显优于对照组。两组术后并发症发生情况及术后24个月生存率比较,差异均无统计学意义。结论:TACE配合;I粒子支架置入治疗肝门部胆管癌效果显著,且具有良好安全性,临床实用性较高,但尚未发现对生存时间有积极影响,还需后续进一步探究。

Objective To explore the effects of transcatheter arterial chemoembolization (TACE) combined with;I particle stent implantation in the treatment of hilar cholangiocarcinoma and its influence on survival time of patients.Methods The clinical data of each 34 patients with hilar cholangiocarcinoma who underwent TACE treatment (control group) and TACE combined with;I particle stent implantation (observation group) were retrospectively analyzed.The tumor diameter and serum total bilirubin (TBIL) level were compared between the two groups before surgery (T0),at 2 months after surgery (T1),at 4 months after surgery (T2) and at 6 months after surgery (T3).The clinical efficacy and occurrence of complications were recorded in the two groups.The survival curves of the two groups were drawn by Kaplan-Meier method,and the survival situation at 24 months after surgery was analyzed in the two groups.Results The tumor diameter at T1,T2 and T3 in observation group was lower than that at T0,and the tumor diameter at T3 was lower than that at T0.The tumor diameter at T3 in control group was lower than that at T0,and there was no significant difference in tumor diameter at T0 and T1 between the two groups.At T2 and T3,the tumor diameter in observation group was significantly lower than that in control group.The serum TBIL level at T1,T2 and T3 in the two groups was lower than that at T0,and the serum TBIL level at T2 and T3 was lower than that at T1.At T0,T2 and T3,there was no statistically significant difference in the serum TBIL level between the two groups.At T1,the serum TBIL level in observation group was higher than that in control group.The clinical efficacy in observation group was significantly better than that in control group.There were no significant differences in the occurrence of postoperative complications and the survival rate at 24 months after surgery between the two groups.Conclusions TACE combined with;I particle stent implantation has significant effects in the treatment of hilar cholangiocarcinoma,and it has good safety and high clinical practicability.However,it has not been found to have a positive impact on survival time,and it needs further investigation.