解放军医药杂志2018，Vol.30Issue(2)：13-17,5.DOI:10.3969/j.issn.2095-140X.2018.02.004
经内镜逆行胰胆管造影引导下放置金属胆管支架联合伽马刀治疗低位肝外胆管恶性梗阻临床观察
Clinical Observation of ERCP-guided Metal Biliary Tract Prosthesis Placement Combined with Gamma Knife in Treatment of Patients with Low Malignant Extrahepatic Bile Duct Obstruction
摘要
Abstract
Objective To investigate application value of endoscopic retrograde cholangiopancreatography(ER-CP)-guided metal biliary stent placement combined with gamma knife in treatment of patients with low malignant extrahe-patic bile duct obstruction. Methods A total of 133 patients with low malignant extrahepatic bile duct obstruction admit-ted during June 2013 and January 2015 were divided into observation group(n=67) and control group(n=66). Con-trol group was treated with ERCP-guided metal biliary stent placement,while observation group was treated with ERCP-guided metal biliary stent placement combined with gamma knife. In two groups,successful rate of operation and drainage effect were compared,and then follow-up for 3 months and 2 years was completed; operative complications and fatality rate were recorded,and examinations of rechecking liver function were performed before, in 1 week and 3 months after operation,and life quality was evaluated at the last time follow-up. Results There were no significant differences in suc-cessful rate of operation and incidence rate of complication between two groups(P>0.05). Drainage satisfaction rate in observation groups was higher than that in control group(P<0.05). In 1 week and 3 months after operation,serum le-vers of total bilirubin,direct bilirubin,aspartate aminotransferase, aspartate aminotransferase and alkaline phosphatase in observation group were significantly lower than those in control group(P<0.05). Two-years survival rate in observa-tion group was significantly higher than that in control group (P <0.05). At the last time follow-up, in observation group,the total score of QLQ-C30 rating scales in function and symptom territory was significantly lower,while health and life quality scores were significantly higher than those in control group (P<0.05). Conclusion ERCP-guided metal biliary stent placement combined with gamma knife in treatment of patients with low malignant extrahepatic bile duct ob-struction may achieve good effect and safety,and it is benefit for improving survival rate and life quality of patients.关键词
胆管肿瘤/胰胆管造影术,内窥镜逆行/支架/放射外科手术Key words
Bile duct neoplasm/Cholangiopancreatography/endoscopic retrograde/Stents/Radiosurgery分类
医药卫生引用本文复制引用
潘胜武,栾晓东,张鑫,张莉,王昌,庞洲..经内镜逆行胰胆管造影引导下放置金属胆管支架联合伽马刀治疗低位肝外胆管恶性梗阻临床观察[J].解放军医药杂志,2018,30(2):13-17,5.基金项目
山西省卫生和计划生育委员会科研课题(ssx2016051) （ssx2016051）
