胆道支架置入联合介入化疗对恶性胆道梗阻患者肝功能及预后的影响

目的:研究胆道支架置入联合介入化疗对恶性胆道梗阻患者肝功能及预后的影响,为临床治疗提供依据。方法:选取2013年2月到2015年2月我院收治的恶性胆道梗阻患者90例,按照随机数字表法将患者分为Ⅰ组、Ⅱ组和Ⅲ组,每组30例,Ⅰ组给予胆道支架置入联合介入化疗,Ⅱ组给予单纯胆道支架置入,Ⅲ组给予保守治疗,比较三组治疗前、后肝功能、并发症、支架通畅率及生存期。结果:治疗前三组谷草转氨酶(AST)、谷丙转氨酶(ALT)、γ-谷氨酰转移酶(r-GT)比较无统计学意义(P0.05),治疗后Ⅰ组和Ⅱ组AST、ALT和r-GT均显著改善,与治疗前和Ⅲ组比较差异具有统计学意义(P0.05),且I组显著优于Ⅱ组,比较差异具有统计学意义(P0.05),Ⅲ组治疗后AST、ALT和r-GT与治疗前比较差异无统计学意义(P0.05);Ⅰ组、Ⅱ组和Ⅲ组并发症发生率比较无统计学意义(P0.05);Ⅰ组术后3个月、6个月和12个月支架通畅率均显著高于Ⅱ组,比较差异具有统计学意义(P0.05);I组生存期显著高于Ⅱ组和Ⅲ组,Ⅱ组高于Ⅲ组,比较差异具有统计学意义(P0.05)。结论:胆道支架置入联合介入化疗治疗恶性胆道梗阻具有较好效果,能明显改善患者肝功,延长患者生存期。

Effect of Biliary Stent Implantation Combined with Interventional Chemotherapy on Liver Function and Prognosis in Patients with Malignant Biliary Obstruction

ABSTRACT Objective: To study the effect of biliary stent implantation combined with interventional chemotherapy on liver function and prognosis in patients with malignant biliary obstruction, to provide basis for clinical treatment. Methods: 90 patients with malignant biliary obstruction treated in our hospital from February 2013 to February 2015 were selected, the patients were divided into group I, group II and group III according to the random number table method, 30 cases in each group, group I was given biliary stent placement combined with interventional chemotherapy, group II was treated with simple biliary stent implantation, Group III was given conservative treatment. The liver function, complications, stent patency rate and survival time of three groups before and after treatment were compared. Results: Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyl transfer enzyme (r-GT) before treatment in the three groups were no significant differences (P>0.05), The r-GT, ALT and AST after treatment were significantly improved in group I and group II, compared with before treatment and group III, the differences were statistically significant (P<0.05), and the group I was significantly better than the group II,the difference was statistically significant (P<0.05), There were no significant differences of AST, ALT, r-GT before and after treatment in the group III(P>0.05); The incidence of complications in group I, group II and group III was not statistically significant(P>0.05); The stent patency rate at 3 months, 6 months and 12 months after operation of group I was significantly higher than that of group II, the difference was statistically significant (P<0.05); The survival time of group I was significantly higher than that of group II and group III, group II was higher than group III, the difference was statistically significant (P<0.05). Conclusion: Biliary stent implantation combined with interventional chemotherapy in the treatment of malignant biliary obstruction has a good effect, which can significantly improve liver function, prolong the survival time of the patients.