Ballinger A B, McHugh M, Catnach S M, Alstead E M, Clark M L
Department of Gastroenterology, St. Bartholomew's Hospital, London.
Gut. 1994 Apr;35(4):467-70. doi: 10.1136/gut.35.4.467.
Palliative treatment is appropriate for most patients with cancer of the head of pancreas. Insertion of a biliary stent relieves jaundice and pruritus but it is not known if stenting affects other symptoms or changes the quality of life. Nineteen patients have completed a standard questionnaire to assess symptom relief and quality of life after stent insertion. After stenting there was complete relief of jaundice and pruritus. Furthermore, there was also considerable improvement in anorexia and indigestion. All patients had anorexia before stent insertion, this was moderate/severe in 13 (68.4%). Anorexia was significantly better (p < 0.01) a week after stenting and this benefit was maintained at 12 weeks (p < 0.01). Sixteen (84.2%) patients complained of indigestion before stenting, moderate/severe in 11 (57.9%). This was significantly better (p < 0.01) a week after stenting with complete relief in six at eight weeks (p < 0.01). Fifteen (78.9%) felt that their mood was good/very good before stent insertion and this was unchanged even at the 12 week assessment. A similar result was obtained for physical health and level of activity. In conclusion stent insertion not only relieves jaundice and pruritus in these patients but also improves other symptoms and quality of life. The considerable improvement in appetite after stenting was of particular benefit.
姑息治疗适用于大多数胰头癌患者。插入胆管支架可缓解黄疸和瘙痒，但尚不清楚支架置入是否会影响其他症状或改变生活质量。19名患者完成了一份标准问卷，以评估支架置入后症状缓解情况和生活质量。支架置入后黄疸和瘙痒完全缓解。此外，厌食和消化不良也有显著改善。所有患者在支架置入前均有厌食症状，其中13例（68.4%）为中度/重度。支架置入一周后厌食症状明显改善（p<0.01），且这种改善在12周时仍持续（p<0.01）。16例（84.2%）患者在支架置入前抱怨有消化不良症状，其中11例（57.9%）为中度/重度。支架置入一周后消化不良症状明显改善（p<0.01），8周时6例完全缓解（p<0.01）。15例（78.9%）患者在支架置入前感觉情绪良好/非常好，即使在12周评估时也没有变化。身体健康和活动水平方面也得到了类似结果。总之，支架置入不仅能缓解这些患者的黄疸和瘙痒，还能改善其他症状和生活质量。支架置入后食欲的显著改善尤为有益。
