I^(125)粒子条支架与普通金属支架治疗恶性梗阻性黄疸患者的疗效分析

Analysis on effects of I^(125)seeds strip stent and common metal stent in treating malignant obstructive jaundice

目的评估I^(125)粒子条支架联合普通金属支架对恶性梗阻性黄疸患者的临床效果。方法回顾性分析2015年6月至2020年9月该院肝胆外科收治的经皮肝穿胆道支架植入术的恶性梗阻性黄疸患者105例,其中44例患者接受了I^(125)粒子条支架植入治疗(粒子条组),61例患者接受普通金属支架植入治疗(支架组)。评估两种治疗方案对恶性梗阻性黄疸患者减黄效果、糖链抗原19-9(CA19-9)水平、术后并发症及生存期的影响。结果两组患者术后黄疸均显著缓解,但两组在减黄效果上无明显差异;术后测血清及胆汁CA19-9均较术前明显下降,两组患者术后第1、7天血清CA19-9及术后第1天胆汁CA19-9均下降,粒子条组术后第3天胆汁CA19-9明显低于支架组,差异有统计学意义(P<0.05)。粒子条组患者术后出现并发症8例,发生率为18.18%;支架组患者术后出现12例,发生率为19.67%,差异无统计学意义(P>0.05)。粒子条组患者中位生存期为6.5个月;支架组患者中位生存期为5.0个月(P<0.05)。结论I^(125)粒子条支架能抑制肿瘤生长、延长患者生存期。

Objective To evaluate the clinical effect of I^(125) seeds strip stent combined with common metal stent in the patients with malignant obstructive jaundice(MOJ).Methods A total of 105 patients with MOJ receiving percutaneous transhepatic biliary stent(PTBS)implantation in the hepatobiliary surgery department of this hospital from June 2015 to September 2020 were retrospectively analyzed,among them 44 cases received I^(125) seeds strip stent implantation(seeds strip group)and 61 cases reecived the common metal stent implantation(stent group).The jaundice reduction effects for MOJ,postoperative changes of CA19-9,postoperative complications and effect on survival time of MOJ patients in the two treatment schemes were evaluated.Results The postoperative jaundice in the two groups was significantly relieved,but there was no significant difference in jaundice reduction effect between the two groups.Serum and bile CA19-9 levels after operation were significantly decreased compared with those before surgery.The postoperative serum and bile CA19-9 levels were significantly decreased compared with before operation,the serum CA19-9 level on postoperative 1,7 d and bile CA19-9 level on postoperative 1 d in the two groups were decreased.The bile CA19-9 level on postoperative 3 d in the seeds strip group was significantly lower than that in the stent group(P<0.05).Eight cases in the seeds strip group developed the postoperative complications with the incidence rate of 18.18%,while there were 12 cases in the stent group with the incidence rate of 19.67%(P>0.05).The median survival time of the seeds strip group was 6.5 months,while which in the stent group was 5 months(P<0.05).Conclusion I^(125) seeds strip stent can inhibit the tumor growth and prolong the survival period.