纳米刀消融联合PTCD术治疗老年不可切除肝门部胆管癌患者预后及肝功能的影响  

Effect of Nano Nnife Ablation Combined with PTCD on Prognosis and Liver Function in Elderly Patients with Unresectable Hilar Cholangiocarcinoma

作　　者：胡佩俊[1] 薛英[2] HU Pei-jun;XUE Ying(Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200437)

机构地区：[1]上海交通大学医学院附属第九人民医院消毒供应中心,上海200437 [2]上海市松江区中心医院供应室,上海200437

出　　处：《医学临床研究》2022年第5期717-720,共4页Journal of Clinical Research

摘　　要：【目的】探讨纳米刀消融联合经皮肝穿刺胆道引流术(PTCD)对老年不可切除肝门部胆管癌预后及肝功能的影响。【方法】回顾性分析上海交通大学医学院附属第九人民医院收治的72例老年不可切除肝门部胆管癌患者的临床资料,根据不同手术治疗方案将其分为对照组(单纯PTCD术治疗,n=40)和观察组(纳米刀消融联合PTCD术治疗,n=32)。对比两组肿瘤缓解率,比较两组治疗前后肝功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)]及肿瘤标记物[糖类蛋白199(CA199)、糖类蛋白125(CA125)、癌胚抗原(CEA)]变化,对比两组并发症发生率及远期疗效。【结果】观察组肿瘤缓解率为87.50%(28/32),显著高于对照组的65.00%(26/40),差异有统计学意义(P<0.05)。治疗后,两组患者ALT、AST、TBIL水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组患者CA199、CA125、CEA水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为21.87%(7/32),低于对照组的12.50%(5/40),差异无统计学意义(χ^(2)=1.13,P=0.29>0.05)。观察组2年的生存率为38.70%,高于对照组的27.02%,但差异无统计学意义(Log Rank=1.473,P=0.225)。【结论】纳米刀消融联合PTCD术治疗老年不可切除肝门部胆管癌预后良好,可改善肝功能,值得推广。【Objective】To investigate the effect of nano knife ablation combined with percutaneous transhepatic biliary drainage(PTCD)on the prognosis and liver function of unresectable hilar cholangiocarcinoma in the elderly.【Methods】The clinical data of 72 elderly patients with unresectable hilar cholangiocarcinoma treated in the Ninth People's Hospital Affiliated to the Medical College of Shanghai Jiaotong University were analyzed retrospectively.According to different surgical treatment schemes,they were divided into control group(PTCD alone,n=40)and observation group(nano knife ablation combined with PTCD,n=32).The changes of glycogen(CEA),total bilirubin(CEA)and aminotransferase(ALT)before and after treatment were compared between the two groups.【Results】The tumor remission rate in the observation group was 87.50%(28/32),which was significantly higher than 65.00%(26/40)in the control group(P<0.05).After treatment,the levels of alt,AST and TBIL in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.05);The levels of CA199,CA125 and CEA in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was 21.87%(7/32),which was lower than 12.50%(5/40)in the control group.The difference was not statistically significant(χ^(2)=1.13,P=0.29>0.05).The 2-year survival rate of the observation group was 38.70%,which was higher than 27.02%of the control group,but the difference was not statistically significant(Log Rank=1.473,P=0.225).【Conclusion】Nano knife ablation combined with PTCD in the treatment of elderly unresectable hilar cholangiocarcinoma has a good prognosis and can improve liver function,which is worthy of popularization.

关 键 词：胆管肿瘤/外科学 胆管 肝内 引流术 穿刺术 消融技术 老年人 预后 

分 类 号：R735.8[医药卫生—肿瘤]