胆管腔内联合瘤体内植入125I粒子治疗不可切除胰头癌  

125I particle bile duct intraluminal and intratumoral implantation for treatment of unresectable pancreatic head carcinoma

作　　者：胡小四 庞青 刘会春[1] 周磊[1] 金浩[1] 王勇[1] 满忠然[1] HU Xiaosi;PANG Qing;LIU Huichun;ZHOU Lei;JIN Hao;WANG Yong;MAN Zhongran(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院肝胆外科

出　　处：《中国介入影像与治疗学》2019年第10期581-584,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：安徽省科技攻关项目(1501541155);安徽省学术和技术带头人及后备人选科研活动经费资助项目(2018D194)

摘　　要：目的观察125I粒子胆管腔内联合瘤体内植入治疗不可切除胰头癌(PHC)的效果。方法回顾性分析72例不可切除PTH患者的临床资料,其中37例接受胆管腔内联合瘤体内植入125I粒子治疗(125I组),35例接受腹腔镜姑息性手术(PS组),对比2组术后肝功能、并发症、中位生存时间及截止随访终点时生存率。结果与术前比较,2组术后1、3及6个月时血清总胆红素、丙氨酸氨基转移酶及天门冬氨酸氨基转移酶水平均降低,白蛋白水平均升高,且术后3、6个月时125 I组较PS组更为显著(P均<0.05)。PS组术后并发症发生率为28.57%(10/35),125I组为21.62%(8/37),组间差异无统计学意义(P=0.496)。PS组患者中位生存时间为9个月,125I组为11个月,组间差异有统计学意义(P=0.041)。结论胆管腔内联合瘤体内植入125I粒子可有效缓解PHC所致胆管梗阻症状,延长患者生存期。Objective To explore the efficacy of 125I particle bile duct intraluminal and intratumoral implantation for treatment of unresectable pancreatic head carcinoma(PHC).Methods Clinical data of 72 patients with unresectable PHC were analyzed retrospectively.Among them 37 patients were treated with 125 I particle bile duct intraluminal and intratumoral implantation(125 I group),and 35 cases underwent laparoscopic palliative surgery(PS group).The postoperative liver function,complications,medial survival time and survival rate at the end of follow-up were compared between the two groups.Results The levels of serum total bilirubin,alanine aminotransferase and aspartate aminotransferase significantly decreased compared with those of preoperation,the level of serum albumin significantly decreased at 1,3 and 6 months of postoperation in both groups,especially in 125I group at 3 and 6 months of postoperation(all P<0.05).The incidence of postoperative complications was 28.57%(10/35)in PS group and 21.62%(8/37)in 125I group,and there was no significant difference between the two groups(P=0.496).The medial survival time was 9 months in PS group and 11 months in 125I group(P=0.041).Conclusion 125I particle bile duct intraluminal and intratumoral implantation can effectively alleviate symptoms of bile duct obstruction and prolong survival time of PHC patients.

关 键 词：胰腺肿瘤 碘同位素 腹腔镜 姑息疗法 介入治疗 

分 类 号：R735.9[医药卫生—肿瘤] R817[医药卫生—临床医学]