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目的 评价胆道支架技术对恶性胆道梗阻的应用价值 ,该技术 5年来的创新及联合抗肿瘤治疗的意义。方法 2 13例胆道恶性梗阻病人 ,采用经皮经肝胆道造影及支架植入术。 10 4例支架植入后并用抗肿瘤治疗。结果 单支架植入 14 2例 ,双支架植入 6 8例。支架植入成功率 98 6 %。黄疸完全解除率 84 8% ,总有效率 95 9%。支架并抗肿瘤治疗 89例与单纯支架植入 5 1例 1年生存率分别为 4 8 3%和 17 6 % ,χ2 =11 2 2 ,P =0 0 1;两年生存率为 14 6 %和 5 9% ,χ2 =3 0 1,P =0 10。支架再阻塞 5 2例 ,4 0例给予动脉化疗栓塞、经皮穿刺外引流或支架内支架治疗 ,黄疸再度消退。结论 (1)胆道支架植入技术成功率高 ,减黄疗效确切。 (2 )应用介入方法可实现梗阻胆管的充分引流和处理支架再狭窄。 (3)支架植入联合抗肿瘤治疗可提高病人生存率。
Objective To evaluate the value of biliary stents in the treatment of malignant biliary obstruction, the innovation of this technique in 5 years and the significance of anti-tumor therapy. Method 2 Thirteen patients with malignant biliary obstruction, percutaneous transhepatic cholangiography and stent implantation. Ten 4 cases were treated with anti-tumor after implantation. Results Single stent implantation was performed in 14 2 cases and double stent implantation in 68 cases. Stent implantation success rate of 98 6%. Jaundice completely relieved 84.8%, the total effective rate 95 9%. The 1-year survival rates of 89 cases treated with anti-tumor therapy and 5 cases treated with simple stent implantation were 48.3% and 17.6%, respectively, χ2 = 11 2 2, P = 0 0 1; the two-year survival rate was 14 6% And 59%, χ2 = 3 0 1, P = 0 10. Fifty-two cases of stent occlusion, 40 cases of arterial chemoembolization, percutaneous puncture or stenting stent treatment, jaundice subsided again. Conclusions (1) The successful rate of biliary stent implantation is high, and the curative effect of reducing yellow is definite. (2) The application of intervention can be achieved obstruction of the bile duct full drainage and treatment of stent restenosis. (3) stent implantation combined with anti-tumor therapy can improve patient survival.