Effect observation of multiple stents combined with 125Ⅰ radioactive particles intracavitary irradiation for malignant obstructive jaundice in the hilar region
Objective To analyze the clinical effect of multiple stents combined with 125Ⅰ radioactive particles intracavitary irradiation for malignant obstructive jaundice(MOJ)in the hilar region.Methods A total of 30 patients with malignant obstructive jaundice in the hilar region were included in the study.All patients received combined treatment of multiple stents and 125Ⅰ radioactive particles intracavitary irradiation.The general operation conditions and the incidence of intraoperative complications of patients were analyzed.The total bilirubin level and quality of life questionnaire of malignant obstructive jaundice 11(QLQ-MOJ11)score before and after surgery,total bilirubin remission rate,jaundice remission rate,survival rate,and incidence of biliary re-obstruction at different time after surgery were compared.Results All 30 patients had single-time stent placement,and a total of 55 stents were inserted in patients.Postoperative imaging examination clearly showed that the biliary stenosis was improved,and the jaundice of the patients gradually subsided and the liver function gradually improved after surgery.The total bilirubin levels at 1 and 3 months after surgery were(39.35±13.96)and(21.30±10.63)μmol/L,which were significantly lower than(144.62±63.73)μmol/L before surgery(P<0.05).The total bilirubin level at 3 months after surgery was significantly lower than that at 1 month after surgery(P<0.05).The remission rates of total bilirubin and jaundice were 100.00％and 100.00％at 3 months after surgery,which were higher than 76.67％and 73.33％at 1 month after surgery(P<0.05).None of the 30 patients had complications such as massive hemorrhage,shock,and cardiovascular accidents.There was no significant difference in the survival rate and the incidence of biliary obstruction at 6,12 and 16 months after surgery(P>0.05).The QLQ-MOJ11 scores of jaundice,pruritus,emaciation and digestive disorders at 3 months after surgery were(26.35±3.85),(27.42±5.63),(43.67±6.93)and(22.63±3.27)points,which were lower than(35.32±4.23),(36.18±6.72),(53.93±6.67)and(30.41±5.71)points before surgery(P<0.05).Conclusion The combination of multiple stents and 125I radioactive particle intracavitary irradiation can significantly improve the effectiveness of clinical treatment for malignant obstructive jaundice in the hilar region,improve the total bilirubin level,reduce the rate of biliary re-obstruction,and improve the quality of life of patients.It is also safe and has high application value.
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