经皮经肝胆道引流与胆道金属支架置入治疗肝门部胆管癌的疗效分析

目的 对比分析经皮经肝胆道金属支架内引流和导管外引流治疗肝门部胆管癌的疗效和安全性.方法选择肝门部胆管癌患者46 例.按照不同引流方法分为金属支架内引流组27 例和导管外引流组19 例.术后7 天复查两组患者肝功能,记录患者术前术后并发症的发生情况.观察两组患者术后生存情况.结果 两组患者治疗后血清ALT?AST?GGT?ALP?TBiL和DBiL 水平均较术前显著下降,差异有统计学意义(P <0.05);相比于导管外引流组,金属支架内引流组患者ALT?AST?GGT?ALP?TBiL 和DBiL 各指标水平下降更显著,差异有统计学意义(P <0.05).金属支架内引流组患者中位生存时间为12.5 个月,略高于导管外引流组患者的(10.6 个月),但是差异无统计学意义(χ2 =2.531,P =0.112).导管外引流组并发症发生率为31.6%,显著高于金属支架内引流组的11.1%,差异有统计学意义(P<0.05).结论 经皮经肝胆道引流途径金属支架置入姑息性治疗肝门胆管癌的疗效确切,安全性高,优于于经皮经肝胆道导管外引流方法.

Efficacy of Percutaneous Biliary Drainage and Biliary Metallic Stent for Hilar Cholangiocarcinoma

Objective To compare the efficacy and safety of percutaneous biliary stent drainage and external drainage in the treatment of hilar cholangiocarcinoma .Methods 46 patients with hilar cholangiocarcinoma ,according to the different drain-age methods,were divided into metal stent drainage group of 27 cases and catheter drainage group of 19 cases.7 days after surger-y,reviewed the liver function of the 2 groups.Recorded the complications of Preoperative and postoperative and observed the sur-vival of the 2 groups after operation .Results The levels of serum ALT,AST,GGT,ALP,TBiL and DBiL in the 2 groups were significantly lower than those of the control group (P<0.05).Compared with the drainage group ,The levels of ALT,AST,GGT, ALP,TBiL and DBiL decreased more significantly (P<0.05).The median survival time was 12.5 months in the metal stenting group,which was slightly higher than that in the catheter drainage group (10.6 months),but the difference was not statistically significant(χ2 =2.531,P=0.112).The complication rate in the external drainage group was 31.6%,which was significantly higher than that in the metal stent drainage group (11.1%).The difference was significant (P<0.05).Conclusion SSFCN can inhibit cell proliferation and promote cell apoptosis ,SSFCN may inhibit the PI3K/AKt signal pathway .