肠内延伸型胆管支架治疗胆管狭窄的临床疗效与安全性分析
作者:
作者单位:

1.北京大学第三医院消化科;2.解放军总医院第五医学中心内窥镜中心;3.郑州大学第五附属医院消化科;4.解放军总医院第五医学中心肝硬化诊疗一区;5.北京大学国际医院消化科

作者简介:

通讯作者:

中图分类号:

基金项目:

国家自然科学基金(82070653);北京市科技计划(Z181100001718149)


Clinical efficacy and safety of enteral extended biliary stent in treatment of biliary stricture
Author:
Affiliation:

Fund Project:

National Natural Science Foundation of China (82070653); Beijing Science and Technology Plan (Z181100001718149)

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 文章评论
    摘要:

    目的 评估肠内延伸型胆管支架治疗胆管狭窄的临床疗效和安全性。 方法 采用多中心回顾性队列研究,纳入2006年2月—2020年4月因肝外胆管狭窄导致梗阻性黄疸的患者共550例,根据置入支架不同,分为传统支架组和肠内延伸型胆管支架组。采用倾向性评分对2组患者基本资料进行匹配,然后比较2组支架通畅时间、术前术后胆红素差值、并发症发生率和住院时间。 结果 550例患者中20例临床资料缺失,35例失访,进行倾向性分析后,最终326例纳入分析,每组各163例。肠内延伸型胆管支架组支架通畅时间为111.0(82.0,192.0)d,相比传统支架组的93.0(70.0,141.8)d明显延长(Z=3.260,P=0.001),术前和术后1周胆红素差值相比传统支架组下降明显[51.2(26.0,114.7) μmol/L比46.0(13.9,81.1) μmol/L,Z=2.095,P=0.036]。传统支架组术后7例(4.3%)出现并发症,肠内延伸型胆管支架组为6例(3.7%);2组中位住院时间均为10.0 d。2组并发症发生率和住院时间比较差异均无统计学意义(P>0.05)。 结论 肠内延伸型胆管支架的通畅时间有效延长,且未增加术后并发症发生率和住院时间,有效性和安全性良好。

    Abstract:

    Objective To evaluate the efficacy and safety of enteral extended biliary stenting for biliary stricture. Methods A multicenter retrospective cohort study was conducted on data of 550 patients with obstructive jaundice due to extrahepatic bile duct stricture between February 2006 and April 2020. Patients were assigned to conventional group (undergoing conventional biliary stent placement) and extended group (undergoing enteral extended biliary stent placement). Propensity score was used to match the basic data of patients of the two groups. Then the stent patency time, bilirubin difference before and after 1 week operation, incidence of complications and hospital stay were compared between the two groups. Results Among the 550 patients, clinical data of 20 cases were missing and 35 failed to be followed up. Finally, 326 patients were enrolled to the study after propensity score matching with 163 cases in each group. The patency time of extended group was 111.0 (82.0, 192.0) days, which was longer than that of conventional group with patency time of 93.0 (70.0, 141.8) days (Z=3.260, P=0.001). Total bilirubin difference value of pre-operation and post-operation was less in extended group [51.2 (26.0,114.7) μmol/L VS 46.0 (13.9, 81.1) μmol/L, Z=2.095, P=0.036]. The rate of early adverse events [4.3% (7/163) VS 3.7% (6/163), P=0.079] and median in-patient days (10.0 days VS 10.0 days, P=0.379) were similar in the two groups. Conclusion Enteral extended biliary stent is effective and safe for treatment of biliary stricture, which can prolong the patency time without increasing postoperative complications and hospital stay.

    参考文献
    相似文献
    引证文献
引用本文

范雪,王艳玲,余盼丽,等.肠内延伸型胆管支架治疗胆管狭窄的临床疗效与安全性分析[J].中华消化内镜杂志,2021,38(6):454-459.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2020-12-16
  • 最后修改日期:2021-02-26
  • 录用日期:2021-01-11
  • 在线发布日期: 2021-07-06
  • 出版日期: 2021-07-01
您是第位访问者

通信地址:南京市鼓楼区紫竹林3号《中华消化内镜杂志》编辑部   邮编:210003

中华消化内镜杂志 ® 2024 版权所有
技术支持:北京勤云科技发展有限公司