| 胆道内照射支架应用于肝门部胆管癌致恶性梗阻性黄疸的初步临床研究 |
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| 引用本文： | 贡桔,夏宁,陈志瑾,郑云峰,孙锦跃,王忠敏.胆道内照射支架应用于肝门部胆管癌致恶性梗阻性黄疸的初步临床研究[J].中国介入影像与治疗学,2017,14(9):521-524. |
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| 作者姓名： | 贡桔 夏宁 陈志瑾 郑云峰 孙锦跃 王忠敏 |
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| 作者单位： | 上海交通大学医学院附属瑞金医院卢湾分院放射科, 上海 200020;上海交通大学医学院附属瑞金医院介入放射科, 上海 200025,上海交通大学医学院附属瑞金医院卢湾分院放射科, 上海 200020,上海交通大学医学院附属瑞金医院卢湾分院放射科, 上海 200020,上海交通大学医学院附属瑞金医院卢湾分院放射科, 上海 200020,上海交通大学医学院附属瑞金医院卢湾分院放射科, 上海 200020,上海交通大学医学院附属瑞金医院介入放射科, 上海 200025 |
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| 基金项目： | 上海市卫生局科研项目（20124137）。 |
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| 摘 要： | 目的评估携带~(125)I粒子的胆道内照射支架治疗肝门部胆管癌致恶性梗阻性黄疸的有效性及安全性。方法选取43例因肝门部胆管癌致恶性梗阻性黄疸患者,采用经皮经肝分别穿刺左右侧胆道分支,于肝门部狭窄处植入~(125)I粒子胆道内照射支架,术后留置引流管3~5天,经造影确认支架通畅后予以拔管,封闭穿刺道。记录患者术前与术后的肝功能变化,并观察术后患者生存时间。结果 BismuthⅠ型5例,植入支架5个;Ⅱ型18例,植入支架36个;Ⅲ型4例,植入支架8个;Ⅳ型16例,植入支架25个,患者术前血清总胆红素和直接胆红素分别为(145.54±65.35)μmol/L和(124.73±35.04)μmol/L,术后分别为(65.91±29.43)μmol/L和(35.50±15.12)μmol/L;与术前相比,术后总胆红素、直接胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、碱性磷酸酶、C-反应蛋白、γ-谷氨酸转肽酶均显著降低(P均0.05),乳酸脱氢酶手术前后差异无统计学意义(P=1.050)。患者中位生存期为13个月(3.0~22.5个月),未出现相关胆道穿孔、胰腺炎、严重胆道感染以及胆道出血等并发症。结论 ~(125)I粒子胆道内照射支架不仅可引流胆汁,减轻黄疸症状,还可近距离内照射胆道肿瘤,起到治疗作用,可延长患者生存时间,有效治疗肝门部胆管癌致恶性梗阻性黄疸。
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| 关 键 词： | 胆管癌 黄疸 梗阻性 胆道腔内放射治疗 碘-125粒子 |
| 收稿时间： | 2017/3/6 0:00:00 |
| 修稿时间： | 2017/7/21 0:00:00 |
Preliminary clinical study of biliary tract irradiation stent for hilar cholangiocarcinoma with malignant obstructive jaundice |
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| GONG Ju,XIA Ning,CHEN Zhijin,ZHENG Yunfeng,SUN Jinyue and WANG Zhongmin.Preliminary clinical study of biliary tract irradiation stent for hilar cholangiocarcinoma with malignant obstructive jaundice[J].Chinese Journal of Interventional Imaging and Therapy,2017,14(9):521-524. |
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| Authors: | GONG Ju XIA Ning CHEN Zhijin ZHENG Yunfeng SUN Jinyue and WANG Zhongmin |
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| Institution: | Department of Radiology, Luwan Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China;Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China,Department of Radiology, Luwan Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China,Department of Radiology, Luwan Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China,Department of Radiology, Luwan Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China,Department of Radiology, Luwan Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China and Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China |
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| Abstract: | |
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| Keywords: | Cholangiocarcinoma Jaundice obstructive Intraluminal brachytherapy 125I seeds |
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