经皮肝穿刺胆道内射频消融联合胆道支架与单纯胆道支架治疗恶性胆道梗阻的效果对比.docVIP

经皮肝穿刺胆道内射频消融联合胆道支架与单纯胆道支架治疗恶性胆道梗阻的效果对比 　　[摘要] 目的 比较经皮肝穿刺胆道内射频消融（RFA）联合胆道自扩式金属支架（SEMS）植入与单纯SEMS植入治疗恶性胆道梗阻的效果及支架通畅率差异。 方法 将2012年6月～2015年3月在海军总医院治疗的25例不可切除的恶性胆道梗阻患者分为两组：10例接受经肝胆道内RFA联合SEMS植入治疗的患者作为治疗组，15例接受单纯SEMS植入治疗的患者作为对照组。比较两组患者治疗前、治疗后1周的总胆红素（TBIL）、直接胆红素（DBIL）、谷氨酸氨基转移酶（ALT）及谷氨酰氨基转肽酶（γ-GT）水平；观察治疗后3、6、9、12个月时两组支架通畅率。 结果 两组患者年龄、性别、疾病谱及术前TBIL、DBIL、ALT、γ-GT水平比较，差异均无统计学意义（P 0.05）；术后1周两组患者TBIL、DBIL、ALT及γ-GT水平均较术前明显下降，差异均有高度统计学意义（P 0.05）；治疗后9、12个月，治疗组支架通畅率高于对照组，差异均有统计学意义（P 0.05）。 结论 与单纯植入SEMS比较，经皮肝穿刺胆道内RFA联合SEMS植入治疗恶性胆道梗阻，可以提高胆道支架植入术后的中远期通畅率。 　　[关键词] 射频消融术；支架植入术；恶性胆道梗阻；黄疸；通畅率 　　[中图分类号] R541.7 [文献标识码] A [文章编号] 1674-4721（2016）10（a）-0099-05 　　Comparison of the effect of stent implantation and percutaneous endobiliary radiofrequency ablation combined with stentin in the treatment of malignant biliary obstruction 　　YANG Chao* LU Wei* 　　Department of Interventional Medicine， Navy General Hospital， Beijing 100048， China 　　[Abstract] Objective To compare the efficacy and stent patency rate between self-expanding metallic stents （SEMS） implantation after endobiliary Radiofrequency Ablation （RFA） and SEMS implantation in the treatment of malignant biliary obstruction （MBO）. Methods Twenty-five patients with unresectable MBO were treated at Navy General Hospital from June 2012 to March 2015， and divided into two groups： 10 patients were treated by SEMS placement after percutaneous endobiliary RFA as treatment group， the other 15 patients received only SEMS implantation as control group. The levels of serum TBIL， DBIL， ALT and γ-GT before and after treatment were compared between the two groups； stent patency rate 3， 6， 9 and 12 months after treatment were observed. Results Age， sex， primary disease and serum TBIL， DBIL， ALT and γ-GT before operation in the two groups had no statistically significant difference （P 0.05）； compared with before operation， levels of the serum TBIL， DBIL， ALT and γ-GT were significantly decreased 1 week after operation， the differences were s