单猪尾抗反流可回收塑料支架在恶性胆道梗阻性疾病中的应用

Application of single pigtail anti-reflux recyclable plastic stent in malignant biliary tract obstruction

摘要:

摘要：目的??在恶性胆道梗阻性疾病中，尤其是高位胆道梗阻性疾病，研制出减黄效果好、反流发生率及梗阻率低、便于回收的单猪尾抗反流可回收塑料支架。方法?对该院34例于2017年2月1日－2019年1月31日因高位恶性胆道梗阻性疾病接受经十二指肠镜置入胆道支架治疗的患者进行分析。共置入塑料胆道支架40个，24例患者仅置入1个普通塑料支架，4例患者仅置入1个单猪尾塑料支架，6例患者各置入1个普通塑料支架后发生梗阻，更换为单猪尾塑料支架。术后随访，比较患者肝功能变化情况、反流发生率及梗阻发生率。结果?①采用新型单猪尾塑料支架治疗高位恶性胆道梗阻性疾病，术后的肝功能指标、反流发生率及梗阻发生率与普通塑料支架相比，差异均有统计学意义（P <0.05）；②同一患者先后分别置入普通塑料支架及单猪尾塑料支架，术后的肝功能指标、反流发生率和梗阻发生率比较，差异均有统计学意义（P <0.05）。结论?单猪尾塑料胆道支架置入术后减黄效果好，反流发生率和梗阻率低，且支架更便于回收，是恶性胆道梗阻性疾病患者，尤其是高位胆道梗阻患者支架置入的更佳选择。

Abstract:

Abstract: Objective?To develop a single pigtail anti-reflux and recyclable plastic stent in malignant biliary tract obstructive diseases especially in high biliary tract obstructive diseases. The stent should be with good yellowing reduction effect, low incidence of reflux and obstruction, and easy recovery.?Methods?34 cases of high malignant biliary obstructive patients from 1st Feb 2017 to 31st Jan 2019 was implanted biliary stents via duodenum endoscope. The clinical data was analyzed: 40 plastic biliary stent was implanted, only 1 of them implanted common plastic stent, 4 of them implanted 1 single pigtail plastic stent, while the other 6 patients implanted 1 common plastic stent occurred obstruction and replaced single pigtail plastic stent. Postoperative follow-up was conducted to compare the changes of liver function, the incidence of reflux and the incidence of obstruction.?Results?New single-pigtail plastic stent was applied to treat high malignant biliary tract obstruction, and the postoperative liver function indexes, reflux incidence and re-obstruction incidence were significantly different from those of common plastic stent (P < 0.05); In the same patient, the common plastic stent and the single pigtail plastic stent were respectively implanted, and the difference in postoperative liver function index, incidence of reflux and incidence of obstruction were statistically significant (P < 0.05).?Conclusion?Single pigtail plastic biliary stent implantation has good yellowing reduction effect, low reflux incidence and re-obstruction rate, and easier stent recovery, making it a better choice for patients with malignant biliary tract obstruction, especially those with high biliary tract obstruction.