摘要
目的探讨CT引导下经皮穿刺化学消融术治疗腹膜后淋巴结转移瘤的疗效。方法回顾性分析CT引导下经皮细针穿刺化学消融术治疗28例腹膜后淋巴结转移瘤患者的临床资料,其中原发病灶为肝癌12例,胃癌10例,胰腺癌3例,结肠癌3例(共31个病灶)。采用22G Chiba针穿刺,制备化学消融剂[无水乙醇(18 ml)、聚桂醇(2 ml)、碘化油(2 ml)、洛铂(10 mg)、表阿霉素(10 mg)按9∶1∶1∶3∶3比例制成混悬液],术后1、3、6、12个月复查增强CT,评价肿瘤体积缩小及坏死情况,采用VAS评分评价疼痛缓解情况,随访时间为12个月。结果 28例(31个病灶)手术均获得成功,术中及术后无严重不良反应。治疗前VAS评分为(6.3±1.5)分,治疗后1个月VAS评分为(1.3±1.2)分(t=13.773,P<0.05);治疗前病灶最大径为(4.2±0.8)cm,治疗后12个月病灶最大径为(1.7±0.5)cm(t=14.755,P<0.05)。结论 CT引导下经皮穿刺化学消融术治疗腹膜后淋巴结转移瘤是一种效果显著的介入方法,其远期疗效和对患者生存期的影响还有待进一步的研究。
Objective To evaluate the efficacy and the application value of CT guided percutaneous chemoablation of intra-abdominal metastatic lymph nodes. Methods Twenty-eight patients with intra-abdominal metastatic lymph nodes were treated by chemoablation under CT guidance. Among them,there were 12 cases of live cancer,10 cases of gastric cancer,3 cases of pancreatic cancer,and 3 cases of cohrnic cancer（ amounting to 31 lesions）. A 22 G Chiba needle was used to puncture. The chemical ablation agent was prepared [ethanol（ 18 ml）,lauromacrogol（ 2 ml）,lipiodol（ 2 ml）,lobaplatin（ 10 mg） and epirubicin（ 10 mg） in a ratio of 9∶ 1∶ 1∶3∶ 3 were made into a suspension]. All the patients were reexamined by contrast-enhanced CT 1,3,6 and 12 months thereafter to evaluate the volume reduction and necrosis of tumors and were followed up for 12 months. Results The operations on all 28 patients（ 31lesions） were successful without serious complications. Pain in all patients was significantly relieved,VAS score before treatment was6. 3 ± 1. 5,a month after the treatment,VAS score was 1. 3 ± 1. 2（ t = 13. 773,P〈0. 05）,the volumes of tumors decreased to varying degrees compared with the preoperative ones. The maximum diameter of the lesions was（ 4. 2 ± 0. 8） cm before operations,and the maximum diameter of the lesions was（ 1. 7 ± 0. 5） cm 12 months after operations（ t = 14. 755,P〈0. 05）. Conclusions CT-guided percutaneous chemoablation of intra-abdominal metastatic lymph nodes is a safe,inexpensive,effective,less invasive and easily manipulated procedure; however,its long term efficacy and influence on the survival period of patients should be further investigated.
出处
《武警医学》
CAS
2016年第8期819-822,共4页
Medical Journal of the Chinese People's Armed Police Force
关键词
放射学
介入性
化学消融
肿瘤转移
radiology
interventional
chemoablation
metastasis
