超声引导下肝胆管内支架置入治疗的材料学特征及其生物相容性

目的:探讨超声引导下肝胆管内支架置入治疗的材料学特征及其生物相容性.方法:由第一作者采用电子检索的方式,在中国期刊全文数据库(CNKI:1997/2009)中以"肝胆管狭窄,支架,超声引导,生物相容性"为检索词行中文文献检索;在Medline数据库(Pubmed:1996/2005)中以"intrahepaticbiliarystricture,stent,ultrasonic guidance,biocompartibility"为检索词行英文文献检索.排除Meta分析、与主题无关的文章以及重复性研究.归纳有关超声引导下肝胆管内支架置入治疗的材料学特征及其生物相容性的文章进行探讨,共纳入21篇文章.结果:对于肝胆管梗阻患者,肝胆管内支架置入与以往外科手术等其他治疗方法相比,具有创伤小,疗效快速,提高生活质量,延长生命的强大优势.在置入支架过程中采用超声实时引导,位置准确,达到"零"创伤,直观引流并保持通畅,并发症发生率低、成本低廉,除做为治疗首选外,其临床应用价值已日益凸显.金属支架在治疗下段梗阻、预防细菌滋生、保持支架较久通畅及并发症少等方面较塑料支架有很大优势.但塑料支架更换较金属支架方便,价格便宜,尤其适用预计生存时间小于3个月的患者,所以,目前仍广泛应用于治疗肝胆管狭窄.结论:所采用支架的材质是影响超声引导下肝胆管内支架置入治疗肝胆管狭窄近、远期疗效的关键.因此,在采用介入超声经皮肝穿刺肝、胆管内支架置入治疗肝胆管狭窄前,要根据梗阻部位、程度、类型、患者身体状态、患者预计生存时间、经济承受能力及预后等方面选择合适的支架,达到快速、安全、减轻病痛,延长生命的满意效果.

Material features and biocompartibility of stent implantation in treating intrahepatic biliary stricture under ultrasonic guidance

OBJECTIVE:To explore the material features and biocompartibility of stent implantation in treating intrahepatic biliary stricture under ultrasonic guidance.METHODS:The Chinese Journal Full-text Database and Medline were retrieved by the first author using search terms of "intrahepatic biliary stricture,stent,ultrasonic guidance,and biocompartibility" both in Chinese and English.Meta analysis,unrelated papers-er repetitive studies were excluded.After that,21 documents concerning the material features and biocompartibility of stent implantation in treating intrahepatic biliary stricture under ultrasonic guidance were analyzed.RESULTS:Compared with the Previousl surgery,stent implantation exhibited advantages such as small trauma,better curative effect,able to improve life quality and prolong life.Ultrasonic guidance has shown its clinical values during stent implantation because of accurate location,few traumas,low complication and cheap cost.The metal stents were preferred in treating lower ureteral obstruction,which is superior to plastic stents in preventing bacteria,maintaining stent patency and reducing complications.However,due to easy change and cheap cost,the plastic stents are widely used in treating intrahepatic biliary stricture,especially for patients within 3-month survival times.CONCLUSION:Materials of the stents play a key role in influencing the short-and long-term effectiveness in treating intrahepatic biiiary stricture.Accordingly,the suitable stents should be selected prior to implantation according to the sites,degree,type of obstruction,physical state,expected survival time,economical ability,as well as the prognosis to reach the goals of relieving pain and prolonging life.