胆道双金属支架联合^(125)I粒子条植入治疗高位恶性梗阻性黄疸的疗效

Effectiveness of percutaneous biliary bi-metallic stent combined with Iodine-125 seeds strand implantation for the treatment of high-grade malignant obstructive jaundice

目的探讨胆道双金属支架联合^(125)II粒子条植入治疗高位恶性梗阻性黄疸的疗效与安全性。方法选取2015年6月~2020年1月我院诊治的67例高位恶性胆道梗阻患者,38例行胆道双支架联合^(125)I粒子条植入为联合组,29例行胆道双支架植入为对照组。分析两组患者术前与术后实验室指标变化情况。比较两组间术后引流有效率、并发症发生率、支架通畅时间及生存时间。结果两组患者术后引流有效率、并发症发生率比较差异无统计学意义(P>0.05)。联合组中位生存时间高于对照组,差异有统计学意义(P<0.05)。联合组患者中位支架通畅时间明显高于对照组,差异有统计学意义(P<0.05)。结论胆道双金属支架联合^(125)I粒子条植入治疗高位恶性梗阻性黄疸安全、有效,可改善临床症状,提高生活质量,延长生存时间及支架通畅时间。

Objective To assess the effictiveness and safety of bilateral metallic biliary stents combined with implantation of Iodine-125 seeds strand in the treatment of high-grade malignant obstructive jaundice.Methods We retrospectively analyszed of 67 patients with a clinical diagnosis of high-grade malignant obstructive jaundice in the department of interventional radiology at the affiliated hospital of xuzhou medical university from January 2016 to December 2020.Of the 67 patients,biliary bilateral metallic stents combined with Iodine-125 seeds strand intraluminal radiation was performed in 38(combined group)and biliary bimetallic stents alone was adopted in 29(control group).Then,we analysed the changes in preoperative and postoperative laboratory parameters in the two groups.The stent patency,survival time and postoperative complications of the two groups were recorded.Results The difference of the drainage efficiency and the complication rate between groups were not statistically significant(P>0.05).The median survival time and the median time of stent patency were significantly higher in the combined group than in the control group,with a statistically significant difference(P<0.05).Conclusion For the treatment of high-grade malignant obstructive jaundice,biliary bimetallic stents combined with Iodine-125 seeds strand intraluminal radiation is effective and safe.It can improve clinical symptoms,enhance the quality of life,prolong stent patency time and patient survival time.