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目的:恶性梗阻性疾病的患病率呈上升趋势,而且病死率很高,预后较差。患者常需接受内镜治疗以达到减黄的目的,但在是否需要联合治疗方案的选择及金属支架与塑料支架的选择上尚有争议,本研究旨在探讨胆道金属支架治疗恶性梗阻性黄疸的预后因素。方法:回顾分析2005年5月～2008年5月采取胆道金属支架治疗的恶性梗阻性黄疸患者的临床资料,85例恶性梗阻性黄疸患者置放胆道支架后,选择性别、年龄、肿瘤类型、出现梗阻时间、梗阻水平、梗阻长度、是否结合化疗等14项因素作为研究对象,进行单因素和多因素分析。结果:单因素分析显示:原发病类型(P=0.047)、术前总胆红素(P=0.027)、梗阻水平(P=0.036)、是否结合化疗(P=0.002)对预后有显著影响,多因素分析显示,原发病类型(P=0.017)、梗阻水平(P=0.049)、是否结合化疗(P=0.002)是影响预后的主要因素。结论:原发病类型、梗阻水平、是否结合化疗是影响胆道金属支架治疗恶性梗阻性黄疸患者预后的独立因素。恶性梗阻性黄疸患者在置入胆道支架后结合化疗可延长生存期。
Objective: The prevalence of malignant obstructive diseases is on the rise, and the mortality rate is very high with poor prognosis. Patients often need endoscopic treatment to achieve the purpose of reducing the yellow, but whether the need for combination therapy options and the choice of metal stents and plastic stents is controversial, this study aims to explore the biliary metal stents for the treatment of malignant obstructive jaundice Prognostic factors. Methods: The clinical data of patients with malignant obstructive jaundice treated with biliary metal stents from May 2005 to May 2008 were retrospectively analyzed. Seventy-five patients with malignant obstructive jaundice were selected for gender, age, tumor type Obstruction time, obstruction level, obstruction length, whether combined with chemotherapy and other 14 factors as the research object, univariate and multivariate analysis. Results: Univariate analysis showed that the prognosis was significantly affected by primary disease type (P = 0.047), preoperative total bilirubin (P = 0.027), obstruction level (P = 0.036) Multivariate analysis showed that the primary disease type (P = 0.017), obstruction level (P = 0.049) and chemotherapy combined with chemotherapy (P = 0.002) were the main factors affecting the prognosis. Conclusion: The type of primary disease, obstruction level, whether combined with chemotherapy is an independent factor affecting the prognosis of patients with malignant obstructive jaundice by biliary metal stent. Malignant obstructive jaundice in patients with biliary stent implantation chemotherapy can extend the survival.