覆膜与非覆膜胆道金属支架治疗胆道恶性梗阻的临床疗效分析

Comparison of covered and uncovered metal stents in treatment of malignant biliary obstruction

摘要:

目的 比较覆膜与非覆膜金属支架治疗胆道恶性梗阻的临床疗效。方法 回顾性分析2003年5月-2014年5月123例胆道恶性梗阻患者临床资料，评价预后主要以死亡为研究终点。随访时间截止2015年3月，统计学分析比较患者生存期及治疗前后各实验室指标的改变，并且统计分析支架通畅时间，并评价其疗效。结果 内镜下覆膜与非覆膜支架均能明显降低胆红素、转氨酶、碱性磷酸酶（ALP）等胆系酶谱，且两组下降程度差异无统计学意义（P >0.05），两组在术后胆管炎发生率及累积生存率方面差异无统计学意义（P >0.05）。术后1年生存率与肿瘤种类相关（r =-1.55，P <0.05）。结论 内镜下覆膜与非覆膜支架治疗胆总管中下段恶性肿瘤相比，具有同样的退黄及缓解肝功能效果，两者在支架开放时间上差异无统计学意义，术后累计生存率方面差异无统计学意义。

Abstract:

Objective To compare the clinical efficacy of covered and uncovered metal stents in treatment of malignant biliary obstruction. Methods 123 cases of malignant biliary obstruction from May 2003 to May 2014. The survival time, the stent patency rates, the effective and biochemical indexes between the two groups were analyze and compared, follow-up period ended in March 2015. Results The level of bilirubin, transaminase, alkaline phosphatase (ALP) was declined after the covered and uncovered metal stents placed by ERCP, and the results of the two groups had no statistical significance (P > 0.05). Also there was no significant difference of the incidence of postoperative cholangitis and the cumulative survival rate between the two groups (P > 0.05). One year survival rates was related to tumor types (r = -1.55, P < 0.05). Conclusions Covered and uncovered metal stents for malignant biliary obstruction have no statistically significant about remission of liver function, stent occusion and the cumulative survival rate.