胆道支架置入联合适形放疗治疗恶性胆道梗阻的疗效观察

目的分析经皮胆道支架置入联合适形放疗对恶性胆道梗阻的治疗效果。方法 10例恶性梗阻性黄疸患者行经皮穿刺胆道金属支架置入联合适形放疗（3D-CRT）治疗,观察黄疸改善情况、靶区肿瘤大小、胆道支架再堵塞影率及患者生存期、生存率。结果 10例患者完成治疗后生化指标提示黄疸（黄疸完全消退6例（60%）,黄疸明显减轻4例,其中6例患者复查CT,提示靶区肿瘤缩小2例,无明显变化4例,存活6个月以上共9例（90%）患者,1例因呼吸衰竭死亡（生存时间：122天）,所有病例支架通畅性100%,无梗阻性黄疸复发,患者平均生存时间为（331±39）天,1年生存率为40%（4/10）,2例至今仍在随访。结论经皮胆道支架置入联合适形放疗是治疗恶性胆管梗阻的有效方法。

Therapeutic effect of percutaneous biliary stent placement combined with conformal radiotherapy for treatment of malignant biliary obstruction

Purpose：To explore therapeutic effect of percutaneous biliary stent placement combined with conformal radiotherapy for treatment of malignant biliary obstruction.Methods：Percutaneous biliary stent placement combined with conformal radiotherapy was performed in 10 patients with malignant biliary obstruction.Improvement of jaundice,the sizes of target tumor,biliary stent re-blockage,survival time and survival rates were observed.Results：After treatment,serum Biochemical Parameters indicated jaundice in all of patients,in four of which jaundice was significantly reduced.The CT scan results in 6 patients showed that two of them experienced reduction of tumor volume,and four of them experienced significant unchanges.Nine cases survived for more than 6 months,and one case died of respiratory failure（surviving time：122 days）.The patency of biliary stent was observed without recurrence of biliary-obstructed jaundice in all of cases.The mean surviving time was 331±39 days.One-year survival was 40%.Two cases were followed up until now.Conclusions：Percutaneous biliary stent placement combined with conformal radiotherapy is an effective method for treatment of malignant biliary obstruction.