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目的:探讨胆管引流联合CT导引下125I粒子植入治疗恶性梗阻性黄疸的安全性、疗效。方法:19例MOJ患者先行介入性减黄术,术后4~6周在CT导引下接受125I粒子植入术。术后2月评估肿瘤近期疗效,统计累计生存率。结果:行胆管内支架植入术3例,单纯性胆管外引流4例,内外引流术12例。单个瘤体内植入粒子数为8~60粒,平均27.1粒。粒子植入术中和术后未见明显并发症发生。肿瘤完全缓解1例,部分缓解8例,有效率47.4%(9/19)。6,12,18,24,30,36月生存率分别为57.9%(11/19),36.8%(7/19),26.3%(5/19),15.8%(3/19),15.8%(3/19),0%(0/19)。结论:胆管引流联合CT引导下125I粒子植入治疗恶性梗阻性黄疸安全,且具有较好的疗效。
Objective: To evaluate the safety and efficacy of biliary drainage combined with CT guided 125I seed implantation in the treatment of malignant obstructive jaundice. Methods: Nineteen patients with MOJ received interventional nervosa first, and 125I seeds were implanted under CT guidance 4 to 6 weeks after surgery. After 2 months of surgery, the efficacy of the tumor was evaluated and the cumulative survival rate was calculated. RESULTS: Biliary stent implantation was performed in 3 cases, simple external bile duct drainage in 4 cases, and internal and external drainage in 12 cases. The number of particles implanted in a single tumor was 8 to 60 particles with an average of 27.1 particles. No significant complications occurred during and after particle implantation. The tumor completely relieved in 1 case, partially relieved in 8 cases, and the effective rate was 47.4% (9/19). The survival rates of 6, 12, 18, 24, 30, and 36 months were 57.9% (11/19), 36.8% (7/19), 26.3% (5/19), 15.8% (3/19), and 15.8%, respectively. (3/19), 0% (0/19). Conclusion: Biliary drainage combined with CT-guided 125I seed implantation is safe and effective in the treatment of malignant obstructive jaundice.