胃、十二指肠恶性梗阻双介入治疗的临床应用  

Dual Interventional Therapy for Malignant Gastroduodenal Obstruction

作　　者：王忠敏[1] 陈克敏[2] 贡桔[1] 伍超贤[1] 郑云峰[1] 

机构地区：[1]上海交通大学附属瑞金医院卢湾分院放射科,上海200020 [2]上海交通大学附属瑞金医院放射科,上海200020

出　　处：《癌症》2007年第10期1107-1111,共5页Chinese Journal of Cancer

摘　　要：背景与目的:胃、十二指肠恶性梗阻患者在发现时多属肿瘤晚期,并伴其它脏器转移。双介入治疗系采用金属内支架解除腔内梗阻及肿瘤供血动脉插管化疗的一种姑息性介入治疗手段。本研究拟探讨双介入法治疗晚期胃、十二指肠恶性梗阻的安全性及初步疗效。方法:对65例胃、十二指肠恶性梗阻患者施行双介入治疗,包括33例胃窦及幽门部梗阻、22例十二指肠降段和水平段梗阻、以及10例胃十二指肠及胃空肠吻合口梗阻;其中9例合并肝转移。所有患者均行金属内支架植入及肿瘤供血动脉插管介入化疗。采用log-rank法分析患者生存情况。结果:65例患者均成功植入内支架,并定期接受高选择性肿瘤供血动脉插管灌注化疗。全组患者3个月累积生存率90%,6个月累积生存率66%,9个月累积生存率49%,1年累积生存率28%。中位生存期为11.9个月。结论:双介入疗法治疗晚期胃、十二指肠恶性梗阻,是一种安全、可行和有效的方法。BACKGROUND ＆ OBJECTIVE： The patients with malignant gastroduodenal obstruction usually have unresectable primary lesion and distant metastasis. Intra-luminal metallic stent implantation followed by intra-arterial chemotherapy via the tumor feeding arteries, so-called ＂dual interventional therapy＂, could temporarily relieve obstructive symptoms. This study was to evaluate the clinical safety and efficacy of dual interventional therapy on advanced malignant gastroduodenal obstruction. METHODS： A total of 65 patients with malignant gastroduodenal obstruction underwent dual interventional therapy. Of the 65 patients, 33 had pyloric antrum obstruction, 22 had duodenal obstruction, and 10 had gastroduodenal obstruction with gastrojejunostomal obstruction; 9 had liver metastasis. The patients＇ survival was analyzed by log-rank test. RESULTS： Stents were successfully implanted into all enrolled patients. No severe adverse events were observed in these patients. The cumulative survival rates at 3, 6, 9, and 12 months after dual interventional therapy were 90%, 66%, 49%, and 28%, respectively. The median survival time was 11.9 months. CONCLUSION： The dual interventional therapy, with metallic stent implantation to relieve malignant obstruction and high-selective intra-arterial chemotherapy to control tumor growth, is a safe, feasible and effective treatment for malignant gastroduodenal obstruction.

关 键 词：胃肿瘤 十二指肠肿瘤 恶性梗阻 食管支架 动脉插管灌注化疗 

分 类 号：R735[医药卫生—肿瘤]