【摘要】：目的探討經(jīng)皮膽道支架聯(lián)合近距內(nèi)放療治療不能手術(shù)切除的肝門膽管癌的可行性、安全性和有效性,以及聯(lián)合治療對患者黃疸復發(fā)和生存期的影響。方法對2014年2月—2015年12月上海仁濟醫(yī)院腫瘤介入科收治的21例不能手術(shù)切除而接受經(jīng)皮膽道支架聯(lián)合近距內(nèi)放療的肝門膽管癌患者及該院同期單純膽道引流或金屬裸支架植入的患者28例進行回顧性分析。觀察手術(shù)成功率、退黃效果及術(shù)后并發(fā)癥發(fā)生率,比較兩組患者生存期和黃疸復發(fā)時間的差異。結(jié)果 21例聯(lián)合治療患者共植入金屬裸支架32枚,放射性125I粒子580顆,手術(shù)成功率100%,治療有效率85.7%,術(shù)后早期并發(fā)癥發(fā)生率9.5%,無手術(shù)相關(guān)死亡發(fā)生。聯(lián)合治療組患者術(shù)后中位黃疸復發(fā)時間為344 d而單純膽道引流或金屬裸支架植入患者的中位黃疸復發(fā)時間為193 d(P=0.035)。聯(lián)合治療組患者中位生存期387 d明顯長于單純膽道引流或金屬裸支架植入患者的256 d(P=0.022)。結(jié)論經(jīng)皮膽道支架聯(lián)合近距離內(nèi)放療作為不能手術(shù)切除的肝門膽管癌患者的姑息治療方案安全有效可行,聯(lián)合治療能夠推遲肝門膽管癌患者的黃疸復發(fā)及延長生存期。
[Abstract]:Objective to investigate the feasibility, safety and efficacy of percutaneous bile duct stent combined with short distance radiotherapy in the treatment of unresectable hilar bile duct carcinoma, and the effect of combined therapy on jaundice recurrence and survival time. Methods from February 2014 to December 2015, 21 patients with hilar bile duct carcinoma who could not be surgically resected and treated with percutaneous bile duct stent combined with short distance internal radiotherapy were treated in the Department of tumor intervention, Shanghai Renji Hospital, and the patients with hilar bile duct carcinoma were treated with simple bile duct drainage or drainage at the same time. 28 patients with bare metal stent implantation were analyzed retrospectively. the results were as follows: (1) 28 patients were treated with bare metal stent implantation. The success rate of operation, the effect of yellowing and the incidence of postoperative complications were observed, and the differences of survival time and recurrence time of jaundice between the two groups were compared. Results A total of 32 bare metal stents and 580 radioactive 125i seeds were implanted in 21 patients. The success rate of operation was 100%, the effective rate was 85.7%, the incidence of early postoperative complications was 9.5%, and no operation-related death occurred. The median recurrence time of jaundice in the combined treatment group was 344 days, while that in the patients with simple bile drainage or bare metal stent implantation was 193 days (P 鈮，

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