灌注化疗和粒子支架治疗高龄贲门癌疗效及术后生活质量对比研究  

Gastric Cardia Carcinoma in Elderly:Diagnostic Efficacy and Postoperative Life Quality——A Comparison of Perfusion Chemotherapy and Seeds Stent Treatment

作　　者：吴涛[1] 王志学[1] 尹晓翔[1] 朱鸷祥 沈松鹤 

机构地区：[1]河南大学第一附属医院介入科,河南开封475001

出　　处：《中国医学影像学杂志》2014年第7期505-507,共3页Chinese Journal of Medical Imaging

摘　　要：目的对比分析灌注化疗(PC)和粒子支架(IS)治疗高龄贲门癌的疗效及对患者术后生活质量的影响。资料与方法 128例高龄胃底贲门癌患者分为胃左动脉灌注化疗组(PC组)和125I粒子支架置入组(IS组),各64例,比较其疗效及并发症等。结果 PC组吞咽困难缓解率及缓解程度均低于IS组:0级缓解率分别为25.00%、3.13%,1级缓解率分别为50.00%、29.69%,2级缓解率分别为25.00%、67.19%,总缓解率分别为75.00%、96.88%(P<0.05)。PC组胃部疼痛、反酸、呃逆、焦虑、出血的发生率均低于IS组(23.44%与51.56%、7.81%与82.81%、7.81%与26.56%、14.06%与40.63%、7.81%与32.81%,P<0.05)。PC组体重增加发生率高于IS组(81.25%与51.56%,P<0.05)。PC组脱发的发生率稍高于IS组(3.13%与0),但差异无统计学意义(P>0.05)。结论两种介入治疗方式对贲门癌均有明显疗效,支架在解除梗阻方面更有优势,3级以下吞咽困难的高龄贲门癌患者行PC治疗可以提高患者的术后生活质量。但吞咽困难不能控制或进一步加重者,应尽早放置125I粒子支架以缓解梗阻,抑制肿瘤生长。Purpose To compare the efficacy of perfusion chemotherapy （PC） and 125I seeds stent （IS） in the treatment of elderly patients with gastric cardia carcinoma and their postoperative life quality.Materials and Methods A total of 128 elderly patients with gastric cardia carcinoma were enrolled in the study and were equally divided into left gastric arterial PC group and IS group.The diagnostic efficacy and complications were compared between the two groups.Results The remission rate and extent to dysphagia were both lower in PC group than those in IS group （remission rate at level 0：25.00％ vs.3.13％; level 1：50.00％ vs.29.69％; level 2：25.00％ vs 67.19％; total remission rate：75％ vs.96.88％,P＜0.05）.The incidences of abdominal pain,gastric acid,hiccup,anxiety and hemorrhage were all lower in PC group than those in IS group （incidence of abdominal pain 23.44％ vs.51.56％,P＜0.05; gastric acid：7.81％ vs.82.81％,P＜0.05; hiccup：7.81％ vs.26.56％,P＜0.05; anxiety：14.06％ vs.40.63％,P＜0.05; hemorrhage：7.81％ vs.32.81％,P＜0.05）.The incidence of weight gain was higher in PC group than that in IS group （81.25％ vs.51.56％,P＜0.05）.The incidence of alopecia was slightly higher in PC group than that in IS group （3.13％ vs.0）,but there was no statistical difference （P＞0.05）.Conclusion The two kinds of interventional methods on carcinoma of gastric cardia both have significant effect.125I seeds stent treatment seems to have advantage in dysphagia relief,whilst elderly patients with cardia dysphagia at or lower than level 3 have better life quality under PC treatment.But to those whose dysphagia cannot be controlled or even aggravate,it is advisable to perform 125I seeds stent treatment as soon as possible for inhibiting tumor growth.

关 键 词：胃肿瘤 贲门 化学疗法 肿瘤 局部灌注 输注 动脉内 碘放射性同位素 近距离放射疗法 治疗结果 手术后并发症 老年人 对比研究 

分 类 号：R573.7[医药卫生—消化系统] R815[医药卫生—内科学]