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目的 比较金属支架与塑料支架 (内涵管 )置入术治疗恶性胆管梗阻的临床疗效。资料与方法 95例实施经皮穿肝胆总管支架置入术的恶性胆管梗阻患者 ,其中 6 1例置入自膨式金属支架 (支架组 ) ,34例置入 10F塑料内涵管 (内涵管组 )。所有患者均随访至死亡或至少术后 1年。用Kaplan Meier方法分析比较两组患者的生存率及支架开通率。结果 支架组患者的 30天死亡率 (6 /6 1,9.8%)低于内涵管组 (9/34 ,2 6 .5 %,P <0 .0 5 )。支架组 30天再阻塞率 (15 .0 %)和并发症发生率 (16 .4%)均明显低于内涵管组 (分别为 32 .4%和 2 9.4%,P <0 .0 1)。支架组中位开通期 (2 30天 )和中位生存期 (2 2 4天 )明显长于内涵管组 (分别为 90天和 94天 ,P <0 .0 1)。结论 金属支架置入术治疗恶性胆管梗阻临床疗效优于内涵管置入术。
Objective To compare the clinical efficacy of metal stents and plastic stents (implantable tubes) in the treatment of malignant biliary obstruction. Materials and Methods 95 cases of malignant biliary obstruction patients undergoing percutaneous transhepatic biliary stenting were enrolled. Among them, 61 cases were implanted with self-expanding metal stents (stent group) and 34 cases were implanted with 10F plastic enteral tubes . All patients were followed up to death or at least 1 year after surgery. The Kaplan Meier method was used to analyze the survival rate and stent opening rate of the two groups. Results The 30-day mortality rate (6/6, 1,9.8%) in the stent group was lower than that in the intubation group (9/34, 26.5%, P <0.05). The 30-day reocclusion rate (15.0%) and complication rate (16.4%) in the stent group were significantly lower than those in the intubated tube group (32.4% vs 29.4%, P <0.01) . Median opening (230 days) and median survival (224 days) were significantly longer in the stent group than in the intubation group (90 and 94 days, P <0.01, respectively). Conclusion The clinical effect of metal stenting in the treatment of malignant biliary obstruction is better than that of intubation.