纳米刀消融术治疗晚期胆囊癌的疗效及安全性分析  

Analysis on efficacy and safety of nano-knife ablation in treating advanced gallbladder carcinoma

作　　者：时志刚 李晓勇[1] 陈艳军[1] 程冰冰[1] 陈升阳[1] 胡水全 仝昊 SHI Zhigang;LI Xiaoyong;CHEN Yanjun;CHENG Bingbing;CHEN Shengyang;HU Shuiquan;TONG Hao(Department of Hepatobiliary and Pancreatic surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第五附属医院肝胆胰腺外科,郑州450052

出　　处：《重庆医学》2022年第19期3293-3297,共5页Chongqing medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200473)。

摘　　要：目的分析纳米刀消融术在晚期胆囊癌治疗中的疗效及安全性。方法收集2016年10月至2018年10月于该院住院治疗的36例晚期胆囊癌患者临床资料,将接受纳米刀消融术联合经皮肝穿刺胆道引流术(PTCD)的患者设为研究组(n=20),将仅接受PTCD的患者设为对照组(n=16),比较两组患者术后2周、1个月、2个月血清总胆红素和糖类抗原19-9(CA19-9)变化情况、生活质量评分、中位生存期及并发症发生情况。结果两组术前血清总胆红素、CA19-9水平均无明显差异(P>0.05),术后2周、1个月、2个月两组血清总胆红素水平均较术前降低(P<0.05),且研究组术后1、2个月明显低于对照组(P<0.05);术后2周、1个月、2个月,研究组血清CA19-9水平较术前明显降低(P<0.05),对照组血清CA19-9水平较术前明显升高(P<0.05),两组术后各时间点血清CA19-9水平均有明显差异(P<0.05)。两组患者术前生活质量各维度评分均无明显差异(P>0.05),研究组术后2个月生活质量各维度评分均明显高于对照组(P<0.05)。术后经PTCD管造影提示,研究组19例患者实现胆道再通,再通率为95.0%;研究组中位生存时间明显长于对照组(13个月vs.3个月,P<0.05)。术后研究组出现1例胆道感染,1例肝脓肿,1例消化道出血,并发症总发生率为15.0%;对照组出现5例胆道感染,并发症总发生率为31.2%,两组并发症总发生率无明显差异(P>0.05)。结论纳米刀消融术能延长患者生存期,提高其生活质量,且安全性高。Objective To analyze the efficacy and safety of nano-knife ablation in the treatment of advanced gallbladder carcinoma.Methods The clinical data of 36 patients with advanced gallbladder cancer treated in this hospital from October 2016 to October 2018 were collected.The patients receiving nano-knife ablation combined with percutaneous transhepaticcholangial drainage(PTCD,n=20)served as the study group,those only receiving PTCD as the as the control group(n=16).The changes of serum total bilirubin and CA19-9,quality of life score,median survival time and complications occurrence at postoperative 2 weeks,1 and 2 months were compared between the two groups.Results There was no statistically significant difference in the levels of serum total bilirubin and CA19-9 before operation between the two groups(P>0.05).The levels of serum total bilirubin at postoperative 2 weeks,1 and 2 months in the two groups were decreased compared with those before operation,moreover,which at postoperative 1 and 2 months in the study group were significantly lower than those in the control group(P<0.05).At postoperative 2 weeks,1 and 2 months,the level of serum CA19-9 in the study group was significantly lower than that before operation(P<0.05),while the level of serum CA19-9 in the control group was significantly higher than that before operation(P<0.05).There were statistically significant differences in serum CA19-9 levels at postoperative time points between the two groups(P<0.05).There were no statistically significant difference in the scores of all dimensions of quality of life before operation between the two groups(P>0.05),while the scores of all dimensions of quality of life at postoperative 2 months in the study group were significantly higher than those in the control group(P<0.05).The postoperative PTCD tube angiography showed that 19 cases in the study group achieved the biliary tract recanalization,with a recanalization rate of 95.0%.The median survival time in the study group was significantly longer than that in the contr

关 键 词：胆囊癌 纳米刀消融术 经皮肝穿刺胆道引流术 生存期 疗效 安全性 

分 类 号：R735.8[医药卫生—肿瘤]