经皮超声引导与开腹术中超声引导植入放射性125I粒子治疗胰腺癌的效果比较

doi:10.13481/j.1671-587x.20170233

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (02): 381-385.doi: 10.13481/j.1671-587x.20170233

经皮超声引导与开腹术中超声引导植入放射性¹²⁵I粒子治疗胰腺癌的效果比较

杜思韵¹, 盖保东², 屈佳¹, 杨冬艳¹

1. 吉林大学中日联谊医院超声科, 吉林长春 130033;
2. 吉林大学中日联谊医院胃肠结直肠肛门外科, 吉林长春 130033

收稿日期:2016-12-20 出版日期:2017-03-28 发布日期:2017-03-31
通讯作者: 杨冬艳,主任医师,硕士研究生导师(Tel:0431-84995070,E-mail:yangdongy@jlu.edu.cn) E-mail:yangdongy@jlu.edu.cn
作者简介:杜思韵(1991-),女,湖南省临湘市人,在读医学硕士,主要从事腹部疾病介入超声诊断和治疗方面的研究。
基金资助:
吉林省科技厅科技发展计划项目资助课题（20130206020SF）

Comparison of effects of ultrasound-guided implantation of radioative ¹²⁵I particles in treatment of pancreatic cancer between percutaneous puncture and laparotomy

DU Siyun¹, GAI Baodong², QU Jia¹, YANG Dongyan¹

1. Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun 130033, China;
2. Department of Gastrointestinal, Colorectal and Anal Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, China

Received:2016-12-20 Online:2017-03-28 Published:2017-03-31

摘要/Abstract

摘要： 目的：探讨经皮超声引导与开腹术中超声引导植入放射性¹²⁵I粒子治疗局部进展期胰腺癌的疗效，为临床治疗进展期胰腺癌术式的选择提供依据。方法：收集73例进展期胰腺癌患者的临床资料，包括超声引导下经皮穿刺放射性¹²⁵I粒子植入术组（A组）42例及开腹术中超声引导放射性¹²⁵I粒子植入术组（B组）31例。比较2组患者疼痛缓解情况、肿瘤局部控制情况、术后生存期及并发症发生情况。结果：A和B组患者疼痛缓解有效率为91.89%和86.40%，2组比较差异无统计学意义（P=0.815）；A和B组患者肿瘤局部控制有效率为71.43%和77.42%，2组比较差异无统计学意义（P=0.564）；A和B组患者中位生存期为11和12个月；1年生存率为36.9%和35.8%，2组比较差异无统计学意义（P=0.664）。A组患者术后7例出现发热；B组患者术后6例出现发热，2例出现小腿肌间静脉血栓，1例出现胃潴留，1例出现胆肠吻合口瘘，1例出现腹胀，1例术后早期出现肠梗阻；2组患者并发症发生率分别为16.67%和38.71%，组间比较差异有统计学意义（P=0.034）。结论：经皮超声引导放射性¹²⁵I粒子植入术治疗局部进展期胰腺癌并发症少，且与开腹术中超声引导放射性¹²⁵I粒子植入术在疼痛缓解、肿瘤局部控制和生存期方面有相同疗效。

关键词: 经皮穿刺, 胰腺肿瘤超声引导, 开腹术, 放射性¹²⁵I粒子

Abstract: Objective: To discuss the clinical effects of implantation of radioative ¹²⁵I seeds by the way of percutaneous puncture and laparotomy under the guidance of ultrasound in the treatment of locally advanced pancreatic cancer, and to provide the basis for choosing surgical methods in treating advanced pancreatic cancer. Methods: The clinical materials of 73 patients with advanced pancreatic cancer were collected, including 42 patients who underwent implantation of radioactive ¹²⁵I seeds by percutaneous puncture(group A) and 31 patients who underwent impantation of radioactive ¹²⁵I seeds by laparotomy(group B). The pain relief, local control of tumor, postoperative survival time and complications of the patients were compared between two groups. Results: The rates of pain relief of the patients in group A and group B were 91.89% and 86.40%,and there was no significant difference(P=0.815).The local control rates of the patients in group A and group B were 71.43% and 77.42%,and there was no significant difference(P=0.564).The medium survival time of the patients in group A and group B were 11 months and 12 months; the one-year survival rates were 36.9% and 35.8%, and there was no significant difference(P=0.664). Seven patients in group A got fever; in group B, six patients got fever, two got calf muscle venous thrombosis, one got gastric retention, one got bilioentric anastomosis, one got abdominal distension and one got intestinal obstruction in the early stage after operation. The incidence rates of complications of the patients in two groups were 16.67% and 38.71%, and there was significant difference(P=0.034). Conclusion: Percutaneous implantation of radioactive ¹²⁵I particles guided by ultrasound causes less complications in the treatment of locally advanced pancreatic cancer. Moreover, the percutaneous way reaches the same effect as the intraoperative way does on the pain relief, local control of tumor and survival time prolonged.

Key words: percutaneous puncture, pancreatic neoplasms, ultrasound-guided, laparotomy, radioative ¹²⁵I seeds

中图分类号:

R735.9

杜思韵, 盖保东, 屈佳, 杨冬艳. 经皮超声引导与开腹术中超声引导植入放射性¹²⁵I粒子治疗胰腺癌的效果比较[J]. 吉林大学学报(医学版), 2017, 43(02): 381-385.

DU Siyun, GAI Baodong, QU Jia, YANG Dongyan. Comparison of effects of ultrasound-guided implantation of radioative ¹²⁵I particles in treatment of pancreatic cancer between percutaneous puncture and laparotomy[J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 381-385.

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经皮超声引导与开腹术中超声引导植入放射性¹²⁵I粒子治疗胰腺癌的效果比较

Comparison of effects of ultrasound-guided implantation of radioative ¹²⁵I particles in treatment of pancreatic cancer between percutaneous puncture and laparotomy

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