ERCP引导下胆管腔内RFA联合支架置入治疗胆总管下段癌合并梗阻疗效及安全性分析

Efficacy and Safety of ERCP Guided Intraluminal RFA Combined with Stent Implantation in the Treatment of Common Bile Duct Carcinoma with Obstruction

目的探讨分析经内镜逆行性胰胆管造影术(ERCP)引导下胆管腔内射频消融(RFA)联合支架置入治疗胆总管下段癌合并梗阻的临床疗效及安全性。方法选取本院就诊的94例胆总管下段癌合并梗阻患者为观察对象,按照随机数字表法分为两组,每组47例。对照组患者采用单独经ERCP引导下联合支架置入进行治疗,研究组患者采用经ERCP引导下胆管腔内RFA联合支架置入进行治疗。回顾性分析两组患者的临床资料,观察分析两组患者治疗前后的肝功能水平,比较两组患者治疗后并发症的发生情况。结果治疗后,研究组患者TB、ALT、ALP及GGT等指标水平均明显低于对照组患者(P<0.05);经治疗后,研究组并发症发生率为21.28%,对照组并发症发生率为17.02%,研究组患者的并发症发生率高于对照组患者,但无统计学差异(P>0.05)。结论经ERCP引导下胆管腔内RFA联合支架置入治疗胆总管下段癌合并梗阻临床疗效肯定,可以有效改善患者黄疸症状及肝功能指标,抑制肿瘤生长,同时不增加患者的并发症发生率,安全性较高,具有临床推广应用价值。

Objective This study aimed to investigate the clinical efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP)guided intraluminal radiofrequency ablation(RFA)combined with stent implantation for the treatment of common bile duct carcinoma with obstruction.Methods A total of 94 patients with lower bile duct carcinoma complicated with obstruction were selected.The patients were divided into the observation group and the control group according to the different treatment methods,each group had 47 cases.The patients in the control group were treated with ERCP guided combined stent implantation,and the patients in the study group were treated with ERCP guided intraluminal RFA combined with stent implantation.The clinical data of two groups were retrospectively analyzed.The liver function levels of the two groups before and after treatment were observed and analyzed,and the incidence of complications after treatment in the two groups was recorded.Results After treatment,the levels of TB,ALT,ALP and GGT in the study group were significantly lower than those in the control group(P < 0.05).The incidence of complications in the study group was 21.28%,and the incidence of complications in the control group was 17.02%.The incidence of adverse reactions in the study group was higher than that in the control group,but there was no statistical difference(P>0.05).Conclusion ERCP guided intraluminal RFA combined with stent implantation is effective in the treatment of lower bile duct carcinoma with obstruction,which can effectively improve the jaundice symptoms and liver function indicators,inhibit tumor growth,and does not increase the incidence of complications.This treatment has high safety and clinical application value.