国产胆道金属支架的临床应用

目的探讨国产胆道金属支架应用的安全性及临床疗效。方法对72例(70例恶性，2例良性)阻塞性黄疸患者施行经皮经肝穿刺植入国产胆道金属支架75枚。结果66例胆道金属支架植入成功，技术成功率92．7％(66／72)。支架植入术后1个月内黄疸缓解率97．0％(64／66)，30d内死亡2例，早期并发症发生率7．6％(5／66)。44例随访2～24个月，随访率66．7％。42例恶性患者，随访5～16个月(平均11．6个月)，9例存活，33例死亡；生存时间2～23个月，中位生存期5．3个月。随访3、6、12个月的支架通畅率分别为92．8％、89．9％、79．4％。支架再阻塞率14．3％(6／42)，中位阻塞期3个月。2例良性梗阻患者，1例支架术后24个月仍通畅，1例术后3个月因其他原因死亡。结论国产胆道金属支架使用方便，临床应用安全可靠，具有临床推广价值。

The clinical application of domestic biliary metallic stents

Objective To determine the clinical efficacy and safety of domestic biliary metallic stents in the management of biliary obstruction. Methods 75 domestic biliary metallic stents were implanted in 66 of 72 patients with obstructive jaundice due to malignant (n=70) and benign stenoses (n=2). Results The technical successful rate was 92.7% (64/66). Palliation with rid of jaundice was achieved in 96.9% (64/66) within 1 month. The 30-day mortality rate was 3% (2/66). Early complications occurred in 7.6% (5/66). 44 patients were followed from 2 to 24 months after treatment. 33 (33/42) of 42 patients with malignancy died after a median survival of 5.3 months (range 2-23 months). The remaining 9 patients (9/42) remained alive with a mean follow-up of 11.6 months. The stent patency rates were 92.8%,89.9% and 79.4% at 3,6,12 months respectively. 6 patients (6/42) presented stent occlusion within a median period of 3 months. One of two patients with benign stenoses sustained a patency duration time of 24 months. One patient died 3 months after treatment. Conclusions The domestic biliary metallic stent implantation is efficacy and safety in the management of biliary obstruction.