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碘-125粒子链支架置入术可有效延长不可切除恶性梗阻性黄疸患者的支架通畅时间和生存期。

Stent placement with iodine-125 seeds strand effectively extends the duration of stent patency and survival in patients with unresectable malignant obstructive jaundice.

作者信息

Pan Tao, Li Ming-An, Mu Lu-Wen, Zhu Duo, Qian Jie-Sheng, Li Zheng-Ran

机构信息

Department of Interventional Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Department of Vascular Surgery, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

Scand J Gastroenterol. 2020 Jan;55(1):123-128. doi: 10.1080/00365521.2019.1707275. Epub 2020 Jan 6.

DOI:10.1080/00365521.2019.1707275
PMID:31906735
Abstract

This study aimed to compare the treatment outcomes and safety between stent placement with or without Iodine- (I) seeds strand for patients with unresectable malignant obstructive jaundice (MOJ). A total of 84 patients with unresectable MOJ treated in our hospital were retrospectively included and divided into the stent group ( = 54) undergoing biliary stent placement and the stent + seeds group ( = 30) receiving stent placement with I seeds strand. The therapeutic outcome, postoperative complications, duration of patient survival and stent patency were compared between groups. Kaplan-Meier survival analysis was performed to compare the duration of patient survival and stent patency between groups. Cox-regression analysis was performed to investigate predictive factors for disease-free survival and overall survival. The stent + seeds group had significantly longer duration of patency (231.57 ± 256.54 vs. 110.37 ± 120.52) and overall survival (310.57 ± 330.54 vs. 173.15 ± 219.40) than the stent group (both  < .05). In addition, Kaplan-Meier survival analysis confirmed that the stent + seeds group had longer duration of patency (log-rank test,  = .001) and higher overall survival rate (log-rank test,  = .020) than the stent group. Furthermore, Cox-regression analysis demonstrated that treatment methods was an independent factor associated with disease-free survival (HR: 0.36, 95% CI: 0.19-0.70;  = .003) and overall survival (HR: 1.01, 95% CI: 1.00-1.01;  < .001). The stent placement with I seeds strand can significantly improve the primary patency rate and overall survival time in MOJ patients.

摘要

本研究旨在比较不可切除性恶性梗阻性黄疸(MOJ)患者在放置支架时加用或不加用碘(I)粒子链的治疗效果及安全性。回顾性纳入我院收治的84例不可切除性MOJ患者,分为接受胆管支架置入的支架组(n = 54)和接受支架置入加I粒子链的支架+粒子组(n = 30)。比较两组的治疗效果、术后并发症、患者生存时间及支架通畅时间。采用Kaplan-Meier生存分析比较两组患者的生存时间及支架通畅时间。进行Cox回归分析以探讨无病生存期和总生存期的预测因素。支架+粒子组的通畅时间(231.57±256.54 vs. 110.37±120.52)和总生存期(310.57±330.54 vs. 173.15±219.40)均显著长于支架组(均P < 0.05)。此外,Kaplan-Meier生存分析证实,支架+粒子组的通畅时间长于支架组(对数秩检验,P = 0.001),总生存率高于支架组(对数秩检验,P = 0.020)。此外,Cox回归分析表明,治疗方法是与无病生存期(HR:0.36,95%CI:0.19 - 0.70;P = 0.003)和总生存期(HR:1.01,95%CI:1.00 - 1.01;P < 0.001)相关的独立因素。放置I粒子链的支架置入术可显著提高MOJ患者的初始通畅率和总生存时间。

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