中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (16): 2991-2994.doi: 10.3969/j.issn.1673-8225.2010.16.035

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

胆管支架材料及类型对置入效果的影响:改善开通率和延长开通时间

赵孝君   

  1. 沈阳市第五人民医院,辽宁省沈阳市  110023
  • 出版日期:2010-04-16 发布日期:2010-04-16
  • 作者简介:赵孝君★,女,1970年生,辽宁省沈阳市人,汉族,2007年中国医科大学毕业,硕士,副主任医师,主要从事急症医学及消化系统疾病的研究。 yxs19700215@126.com

Effects of materials and types of biliary tract stents on implantation effectiveness: Enhancing patency rate and prolonging patency time

Zhao Xiao-jun   

  1. Fifth People’s Hospital of Shenyang, Shenyang  110023, Liaoning Province, China
  • Online:2010-04-16 Published:2010-04-16
  • About author: Zhao Xiao-jun★, Master, Associate chief physician, Fifth People’s Hospital of Shenyang, Shenyang 110023, Liaoning Province, China yxs19700215@126.com

摘要:

背景:胆管内支架有可膨胀式金属支架和塑料内涵管两种,前者的开通时间比后者长,但进口品价格昂贵,故对选择金属支架还是塑料内涵管存在争议。因此,如何选择适宜的支架,改善支架的开通率和延长支架的开通时间,是目前医学界研究的热点。
目的:阐述胆管支架的临床应用进展,并探讨胆管支架的材料、类型对置入后支架开通率及开通时间的影响。
方法:作者以“胆管内支架,金属支架,塑料支架,阻塞,再狭窄”为检索词,在中国期刊全文数据通信(CNKI:2002/2008)及Medline 数据库(Pubmed: 1974/2006)中,采用电子检索的方式进行文献检索。排除Meta分析及重复性研究,共检索到20篇文献,从胆管支架置入治疗进展,不同材料及类型胆管支架对开通率、开通时间的影响,以及预防支架梗阻等方面进行探讨。
结果与结论:胆管内支架置入是恶性胆管梗阻姑息治疗的最佳方法,并发症少。胆管内支架主要包括金属支架和塑料支架,两种支架的生物相容性均有待提高。金属支架在预防细菌滋生,保持支架较久通畅方面较塑料支架有很大优势,但价格昂贵;塑料胆管支架较易发生细菌附着、胆泥淤积导致支架阻塞,但具有易于更换、价格低廉等优点。肝内胆管支架与各种放射疗法的联合应用均可延长支架的有效开通期限,并有效的防治支架梗阻。提示胆管支架置入是临床治疗良恶性胆道狭窄的最有效手段,胆管内支架置入和放射疗法相结合可预防支架梗阻。

关键词: 胆管内支架, 金属支架, 塑料支架, 阻塞, 再狭窄

Abstract:

BACKGROUND: Biliary tract stents comprise two types: expanding metallic stents and plastic stents, the patency time of the former is shorter than the latter, but the cost is higher. Thus, it is dispute which kinds of stent should be selected. Accordingly, it becomes a research topic how to improve patency rate and prolong patency time using cheap stents.
OBJECTIVE: To explain the progress of biliary tract stents and to explore the effects of materials and types of biliary tract stents on patency rates and patency times.
METHODS: The Chinese Journal Full-text Database and Medline were retrieved by the first author using search terms of “biliary stent, metallic stent, plastic stent, occlusion and stricture” both in Chinese and English. Meta analysis or repetitive studies were excluded. After that, 20 documents concerning the effects of materials and types of biliary tract stents on patency rates and patency times were analyzed.  
RESULTS AND CONCLUSION: Biliary stent implantation is the preferred way for alleviative treatment of malignant obstruction of bile duct with few complications. Biliary tract stents comprise two types comprise metallic stents and plastic stents, the biocompatibility of both stents need to be improved. The metallic stents exhibited advantages in preventing bacteria, maintaining stent patency and reducing complications, but the high cost limited its application. Though plastic stents easily lead to stent occlusion due to bacteria adhesion and biliary siltation, however, it has merits of easy change and cheap cost. The combination of biliary stent implantation and radiotherapy can prolong effective patency period and prevent stent occlusion. The results demonstrated that biliary stent implantation is best methods for treating malignant obstruction of bile duct, and combined biliary stent implantation with radiotherapy can prevent stent obstruction.

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