125I粒子条胆道腔内放射联合胆道支架植入术治疗恶性梗阻性黄疸

Clinical study of 125 iodine particle strip biliary cavity radiation combined with biliary stent implantation in the treatment of malignant obstructive jaundice

目的研究125 I粒子条胆道腔内放射联合胆道支架植入术治疗恶性梗阻性黄疸的临床效果。方法选取淮南市第一人民医院2017年5月至2021年10月就诊的恶性梗阻性黄疸患者56例,按治疗方法将其分成对照组15例,研究组41例。比较两组总生存时间、肝功能、并发症、临床疗效、支架通畅时间。结果两组术后4周的直接胆红素(DBil)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)以及总胆红素(TBil)均低于术前(P<0.05),但两组术后4周的ALT、TBil、DBil、AST比较差异无统计学意义(P>0.05)。研究组、对照组临床成功率分别为95.12%(39/41)、14/15例,差异无统计学意义(P>0.05)。对照组、研究组总并发症发生率分别为2/15例、14.63%(6/41),差异无统计学意义(P>0.05)。研究组、对照组中位支架通畅时间分别为241 d、147 d,研究组支架通畅时间函数优于对照组(P<0.05)。对照组、研究组中位生存时间分别为165 d、253 d,研究组总生存函数优于对照组(P<0.05)。结论胆道支架植入术联合125 I粒子条胆道腔内放射治疗可延长恶性梗阻性黄疸患者总生存时间与支架通畅时间,疗效显著,改善患者肝功能,且安全可靠。

Objective To study the clinical effect of 125 iodine particle strips combined with biliary stents in the treatment of malignant obstructive jaundice.Methods 56 patients with malignant obstructive jaundice from May 2017 to October 2021 were selected and divided into control group(15 cases)and study group(41 cases).In the two groups,the overall survival time,liver function,complications,clinical efficacy and stent patency time were compared.Results Direct bilirubin(DBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels of 4 weeks after surgery were lower than before surgery(P<0.05),but there were no differences in ALT,TBIL,DBIL and AST 4 weeks after surgery between the two groups(P>0.05).The clinical success rates of the study group and the control group were 95.12%and 93.33%,respectively,with no difference(P>0.05).The total complication rates of the control group and the study group were 13.33%and 14.63%,respectively,with no difference(P>0.05).The median stent patency time of the study group and the control group were 241 d and 147 d,respectively,and the study group with function of stent patency time was better than control group(P<0.05).The median survival time of the control group and the research group was 165 d and 253 d,respectively,and the study group with total survival function was better than control group(P<0.05).Conclusion Biliary stent implantation combined with biliary cavity radiotherapy with 125 iodine particle strips can prolong the overall survival time and stent patency time of patients with malignant obstructive jaundice,which is effective,improves liver function,and is safe and reliable.