目的  比较SEMS 和 TDT 置入在恢复恶性大肠梗阻中的应用价值。方法  收集单中心2012~2016 年接受SEMS （n=26）和TDT（n=22）置入的 48 例恶性大肠梗阻患者资料，比较两组技术成功率、临床症状缓解情况、并发症、达开 放 EN 时长、功能状态评估及后续治疗选择等指标。结果  两组技术成功率均为100%，无穿孔发生。SEMS 组和TDT 组梗 阻症状缓解比例分别为96.2%（25/26）和95.5%（21/22），导管移位分别为7.7%（2/26）和18.2%（4/22）（P=0.26，达 开放EN时长为2 IQR（0~2）天和 3 IQR（2~5）天（P=0.001），KPS功能状态评分为75 IQR（50~80）分和 35 IQR（30~50） 分（P=0.001）。接受外科手术、单用化疗和不接受手术或化疗而行口服营养补充的患者比例在SEMS组为30.8%（8/26）、 7.7%（2/26）和61.5%（16/26），在 TDT 组为31.8%（7/22）、0 和 59.1%（13/22）；其中二期手术的患者比例在SEMS 和 TDT 组分别为25.0%（2/8）和57.1%（4/7），吻合口瘘仅见于TDT 组（1/7）。结论  SEMS 和 TDT 法均能有效缓解恶 性大肠梗阻症状，技术成功率及安全性好。SEMS 开放 EN 更快、术后功能状态更优。

Objective To compare the outcomes after SEMS or TDT placement in patients with malignant large-bowel obstruction (MLBO). Methods 48 patients with MLBO from the clinical unit accepted SEMS (n=26) or TDT (n=22) placement from 2012 to 2016 were collected. The outcomes evaluation, successful rates of placement, clinical outcomes after decompression, complications, the timing of resuming to EN, Karnofsky Performance Status (KPS) scoring and the following-up therapeutic options were included. Results Technical success were achieved in 100% patients in both groups. Clinical success rates were 96.2% (25/26) for SEMS and 95.5% (21/22) for TDT. There was no perforation found in any group, while 7.7% (2/26) in SEMS and 18.2% (4/22) in TDT group experiencing a complication of displacement (P=0.26). 2 IQR(0~2) days and 3 IQR(2~5) days should be taken to resume to EN in each group, respectively (P=0.001). KPS scores were significantly higher in patients with SEMS (75 IQR50~80) than in those with TDT (35 IQR30~50) (P=0.001). There were 30.8% (8/26) patients undergoing stenting as bridge to surgery, 7.7% (2/26) patients for chemotherapy only and 61.5% (16/26) for palliation and nutritional therapy in SEMS group, while 31.8% (7/22), 0 and 59.1% (13/22) in TDT group, respectively (P=0.36). The patients requiring stoma creation were 57.1% (4/7) in TDT group and 25.0% (2/8) in SEMS group, respectively, while postoperative anastomotic leakage was found only in TDT group (1/7). Conclusions Both SEMS and TDT placement could achieve a clinical relief for MLBO effectively. However, SEMS placement is associated with earlier EN and is more obvious postoperative quality-of-life benefits in MLBO.