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首页> 外文期刊>Radiology >Common bile duct obstruction due to malignancy: treatment with plastic versus metal stents.
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Common bile duct obstruction due to malignancy: treatment with plastic versus metal stents.

机译：恶性肿瘤引起的胆总管阻塞：塑料或金属支架治疗。

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PURPOSE: To compare the clinical efficacy and treatment costs of plastic versus metal biliary stents. MATERIALS AND METHODS: In a randomized trial, 101 patients with malignant common bile duct obstruction underwent transhepatic stent implantation and were followed up until death. Patients were stratified into risk and nonrisk groups. Forty-nine patients received 12-F plastic stents, and 52 received expandable metal stents. Plastic endoprostheses were placed in a two-step procedure; metal stent, in a single procedure. Kaplan-Meier analyses were used to compare patient survival and stent patency rates. RESULTS: The 30-day mortality rate was significantly lower for metal stents (five of 52 [10%]) than plastic stents (12 of 49 [24%]; P = .05). The obstruction rate was 19% (10 of 52; median patency, 272 days) for metal stents and 27% for plastic stents (13 of 49; median patency, 96 days; P < .01). Median time until death or obstruction was longer for metal stents (122 vs 81 days; P < .01). Placement of metal stents was associated with shorter hospital stay (10 vs 21 days; P < .01) and lower cost (Dollars 7,542 vs Dollars 12,129; P < .01). CONCLUSION: Use of self-expanding metal stents appears to show substantial benefits for patients and to be cost-effective.
机译：目的：比较塑料和金属胆道支架的临床疗效和治疗费用。材料与方法：在一项随机试验中，对101例恶性胆总管梗阻患者行经肝支架植入术，并随访直至死亡。将患者分为危险和非危险组。四十九名患者接受了12-F塑料支架，而52例接受了可扩张金属支架。塑料内假体分两步放置;金属支架，只需一个步骤。 Kaplan-Meier分析用于比较患者生存率和支架通畅率。结果：金属支架的30天死亡率显着低于塑料支架（5个为52 [10％]）（塑料支架为12天，共49个[24％]; P = 0.05）。金属支架的阻塞率为19％（52个中的10个;中位通畅期272天），塑料支架的阻塞率为27％（49个中的13个;中位通畅期96天; P <.01）。金属支架直到死亡或阻塞的中位时间更长（122天vs 81天; P <0.01）。金属支架的放置与住院时间较短（10天比21天; P <.01）和较低的成本（美元7,542对美元12,129; P <.01）相关。结论：使用自扩张金属支架似乎对患者显示出巨大的益处，并且具有成本效益。

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