[1]任建庄,张 凯,李腾飞,等.中下段胆总管癌致恶性梗阻性黄疸介入治疗疗效分析[J].介入放射学杂志,2015,(05):409-413.
　REN Jian zhuang,ZHANG Kai,LI Teng fei,et al.Interventional therapy for malignant obstructive jaundice caused by cholangiocarcinoma located at middle low segment of common bile duct： analysis of curative effect[J].journal interventional radiology,2015,(05):409-413.
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中下段胆总管癌致恶性梗阻性黄疸介入治疗疗效分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2015年05期
页码:
409-413
栏目:
非血管介入
出版日期:
2015-05-25

文章信息/Info

Title:
Interventional therapy for malignant obstructive jaundice caused by cholangiocarcinoma located at middle low segment of common bile duct： analysis of curative effect
作者:
任建庄;  张 凯;  李腾飞;  段旭华;  黄郭灏;  张萌帆;  韩新巍
Author(s):
REN Jian zhuang;  ZHANG Kai;  LI Teng fei;  DUAN Xu hua;  HUANG Guo hao;  ZHANG Meng fan;  HAN Xin wei
Department of Interventional Radiology， First Affiliated Hospital， Zhengzhou University， Zhengzhou， Henan Province 450052， China
关键词:
【关键词】 胆管癌;  梗阻性黄疸;  介入治疗
文献标志码:
A
摘要:
【摘要】 目的 探讨经皮经肝胆汁引流（PTCD）术后不同抗肿瘤治疗方式对胆管癌致恶性梗阻性黄疸患者生存期影响。方法 收集2012年1月至2013年3月治疗的60例经胆道钳夹活检明确诊断为胆总管中、下段腺癌，按照TNM肿瘤分期分为Ⅱ期9例，Ⅲ期39例、Ⅳ期12例。按照分化程度区分高分化者9例、中分化者37例、低分化者14例。将此60例患者纳入研究中，所有患者行引流管置入及支架植入以解除黄疸症状，根据后续抗肿瘤治疗方式不同将患者分为3组，A组引流手术后行规律动脉灌注化疗；B组引流手术后行胆道内粒子链植入；C组引流手术后行规律动脉灌注化疗及胆道内粒子链植入。应用SPSS17.0统计软件进行统计学分析。肿瘤患者的死亡因素分析采用多变量Cox比例风险回归分析，以P＜0.05为差异有统计学意义。结果 A组中位生存期为（186.0±36.4）d，B组中位生存期为（183.0±26.5）d，C组中位生存期为（252.0±43.6）d。肿瘤患者的死亡因素分析采用多变量Cox比例风险回归分析，患者生存期影响因素经多变量Cox比例风险回归分析显示，肿瘤分期［HR=8.434，95%CI（3.41~20.090）］是死亡的危险因素，治疗方式［HR=0.616，95%CI（0.429~0.884）］是死亡的保护因素，肿瘤分化程度（Score检验，?字2=0.197，P=0.657）与死亡无关。与A组相比，B组患者的死亡风险无明显差异［HR=1.012，95%CI（0.558~2.179）］，而C组治疗方式［HR=0.334，95%CI（0.148~0.075）］是死亡的保护因素。结论 肿瘤TNM分期及不同治疗方式对中下段胆总管癌患者生存时间有影响，中下段胆总管癌致梗阻性黄疸患者引流术后应行化疗及内放疗相结合的综合介入治疗，确能延长患者生存期。

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备注/Memo

备注/Memo:
 （收稿日期：２０１4-０9-17）
（本文编辑：俞瑞纲）
更新日期/Last Update: 2015-05-19