CAJ | 학술논문

背景:在堵塞的支架中再次置入金属或塑料支架可解决支架的堵塞问题,然而关于支架间如何搭配组合将使患者受益更大却一直存在着争论.目的:对比恶性胆道梗阻金属支架堵塞后再次在其内置入不同种类支架之间的临床效果.方法:收集在南昌大学第二附属医院行经内镜胆道金属支架置入的,且在原支架堵塞后再次在其内置入另一支架的中、低位胆道恶性梗阻患者83例,并根据原支架与再次置入支架的不同搭配组合形式,将以上患者分为3组,即覆膜金属支架组、无覆膜金属支架组和塑料支架组.结果与结论:在原金属支架堵塞后,再次置入覆膜金属支架的通畅时间显著长于塑料支架(P<0.05);覆膜金属支架组的支架累计通畅时间显著长于无覆膜金属支架组(P <0.05-0.01).提示经内镜置入胆道金属支架治疗中、低位胆道恶性梗阻时,在原金属支架和支架堵塞后再次置入金属支架时,使用≥1根覆膜支架的累计通畅时间显著长于先后2次置入无覆膜金属支架者.
배경:재도새적지가중재차치입금속혹소료지가가해결지가적도새문제,연이관우지가간여하탑배조합장사환자수익경대각일직존재착쟁론.목적:대비악성담도경조금속지가도새후재차재기내치입불동충류지가지간적림상효과.방법:수집재남창대학제이부속의원행경내경담도금속지가치입적,차재원지가도새후재차재기내치입령일지가적중、저위담도악성경조환자83례,병근거원지가여재차치입지가적불동탑배조합형식,장이상환자분위3조,즉복막금속지가조、무복막금속지가조화소료지가조.결과여결론:재원금속지가도새후,재차치입복막금속지가적통창시간현저장우소료지가(P<0.05);복막금속지가조적지가루계통창시간현저장우무복막금속지가조(P <0.05-0.01).제시경내경치입담도금속지가치료중、저위담도악성경조시,재원금속지가화지가도새후재차치입금속지가시,사용≥1근복막지가적루계통창시간현저장우선후2차치입무복막금속지가자.
BACKGROUND:Reimplantation of metal ic and plastic biliary stents in the obstructed scents can solve obstruction. However, it is debatable what a kind of combinations in stents can have more benefits for patients. OBJECTIVE:To compare clinical effects of the reimplanted different kinds of stents for occluded primary metal ic stents in malignant biliary obstruction. METHODS:Total y 83 patients with malignant biliary obstruction were col ected. They underwent endoscopic metal biliary endoprothesis and secondary biliary stent placement in the medium and low levels of the other stent as“stent-in-stent”in the Second Affiliated Hospital of Nanchang University. The patients were divided into three groups according various combinations in primary and secondary implanted stents:covered metal ic stent group, uncovered metal ic stent group and plastic stent group (5 covered-plastic, 10 uncovered-plastic). RESULTS AND CONCLUSION:After the primary metal ic stent was obstructed, the patent time of reimplanted covered metal ic stents was significantly longer than that of plastic stents (P<0.05). Compared with the uncovered metal ic stent group, the cumulative patent time in the covered metal ic stent group was obviously longer (P<0.05-0.01). These results suggest that as the primary metal ic stents were obstructed, covered metal ic stents (at least one in the primary and/or secondary procedure) can provide longer cumulative patent time than uncovered metal ic stents in both procedures for malignant biliary obstruction at medium and low levels treated by mendoscopic metal biliary endoprothesis.