碘化油与改良微球注射法栓塞胃肠道源性肝转移瘤的初步临床研究  

Preliminary clinial study of iodized oil and improved microspheres injection embolization on heptic metastasis from gastrointestinal tumors

作　　者：肖全平[1] 牛焕章[1] 高万勤[1] 杨海[1] 李东民[1] 杜廷伟[1] 王彤 Xiao Quanping;Niu Huanzhang;Gao Wanqin;Yang Hai;Li Dongmin;Du Tingwei;Wang Tong(Department of Interventional Radiology,the First Affiliated Hospital of Henan Science and Technology University,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院介入科,洛阳471000

出　　处：《中华放射学杂志》2020年第11期1112-1116,共5页Chinese Journal of Radiology

摘　　要：目的对比碘化油栓塞与改良微球注射法栓塞治疗胃肠道源性肝脏转移瘤的初步临床疗效。方法前瞻性收集2015年7月至2017年7月于河南科技大学第一附属医院行经皮选择性肝动脉灌注化疗栓塞术(TACE)的胃肠道源性肝脏转移瘤患者100例,采用随机数字法将患者随机分为碘化油组和微球组。碘化油组45例,常规先灌注化疗药物,再用碘化油与表阿霉素乳化剂栓塞;微球组55例,先灌注同样化疗药,后行表阿霉素与栓塞微球交替灌注化疗栓塞。观察术后不良反应,采用χ²检验比较两组患者术后各时间点局部有效率,采用Kaplan-Meier法进行生存分析,以Log-rank法比较两组间生存率。结果全部患者手术均获得成功,无严重致死及致残性并发症发生。术后随访时间(18.7±3.4)个月。碘化油组术后1、3、6、12、24个月的局部有效率为71.1%(32/45)、68.9%(31/45)、51.1%(23/45)、28.9%(13/45)、6.7%(3/45),微球组为90.9%(50/55)、89.1%(49/55)、72.7%(40/55)、49.1%(27/55),23.6%(13/55),微球组优于碘化油组,差异有统计意义(P<0.05)。碘化油组中位生存期12个月,微球组中位生存期17个月,差异有统计学意义(χ²=8.238,P=0.004)。微球组4例患者术后1周内出现肝脓肿,经引流抗炎、治疗后好转。结论对于胃肠道源性肝转移瘤患者,采用改良微球栓塞法对肿瘤的局部有效率高于碘化油栓塞,且能延长肿瘤患者生存时间,是治疗胃肠道源性肝转移瘤的有效方法。Objective To compare the preliminary clinical efficacy of iodized oil embolization and improved microspheres injection embolization in patients with hepatic metastasis from gastrointestinal tumors.Methods In total 100 patients with hepatic metastasis from gastrointestinal tumors were perspective enrolled from July 2015 to July 2017 in the First Affiliated Hospital of Henan University of Science and Technology.The patients were randomly divided into iodized oil group(45 cases)and microspheres group(55 cases)using random number table.The patients in iodized oil group were firstly received regular perfusion chemotherapy,then underwent the embolization with Iodized oil and epirubicin emulsifier.As for the microspheres group,the patients were received epirubicin and microspheres perfusion and embolization alternately after the same regular perfusion chemotherapy.The post-operation complications were observed.The effective rate of tumor controling at each time point was compared between two groups usingχ^2 test.Kaplan-Meier method was used to perform the survival analysis.Log-rank test was used to compare the survival rate between two groups.Results The operation was successfully performed in all the patients,without severe complications found.The follow up time was 18.7±3.4 months.The tumor control rates of 1,3,6,12 and 24 months after operation in the iodine oil group were 71.1%(32/45),68.9%(31/45),51.1%(23/45),28.9%(13/45),6.7%(3/45)respectively;while in microspheres group were 90.9%(50/55),89.1%(49/55),72.7%(40/55),49.1%(27/55),23.6%(13/55),respectively.The tumor control rate in microspheres group was superior to that in iodine oil group(P<0.05).The median lifetime was 12 months and 17 months for iodine oil group and microspheres group respectively,with significant difference(χ²=8.238,P=0.004)found between two groups.As for the microspheres group,the liver abscess was found in one week after operation in 4 patients,who were cured after drainage and anti-inflammatory treatment.Conclusion The improved microsphere

关 键 词：肿瘤转移 栓塞 治疗性 碘化油 微球 胃肠道肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]