经皮动脉化疗栓塞术治疗中晚期胃癌的临床分析  

Clinical analysis of transcatheter arterial chemoembolization for advanced gastric cancer

作　　者：夏媛媛 梅丁莲 祁亚龙 陈力强 XIA Yuanyuan;MEI Ding-lian;QI Ya-long(Beijing Mentougou District Hospital,Beijing 102300,China)

机构地区：[1]北京市门头沟区医院肿瘤与介入科,102300

出　　处：《中国现代药物应用》2023年第10期46-49,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 观察经皮动脉化疗栓塞术治疗中晚期胃癌的临床疗效。方法 15例中晚期胃癌患者,均进行经皮动脉化疗栓塞术治疗。分析治疗及随访情况、临床症状改善情况、肿瘤标志物、临床疗效、近期不良反应发生情况。结果 15例患者全部手术成功,平均介入手术时间为(118±45)min。化疗栓塞血管中胃左动脉6例,胃左+胃网膜右动脉2例,胃左+胃网膜右动脉+肝动脉1例,胃左+胃网膜左动脉+肝动脉2例,胃左+胃十二指肠动脉3例,胃左+胃右+胃网膜右动脉1例。平均住院时间为(3.9±0.96)d。随访结束后,15例患者中死亡5例,中位生存期为9个月,其中1例患者最长存活13个月;现存活患者10例,平均生存期已超过15.6个月。12例上腹饱胀不适、上腹痛患者中8例得到改善,2例黑便患者均得到改善,1例便潜血阳性患者转阴,2例反酸烧心患者改善,1例吞咽困难患者得到明显改善,4例恶心、纳差患者中1例得到改善。多数患者治疗后食欲增加,腹痛减轻。术前癌胚抗原(CEA)升高者5例,其中4例术后下降;术前糖类抗原724(CA-724)升高者5例,其中4例术后下降;术前糖类抗原125(CA-125)升高者3例,术后均下降;术前甲胎蛋白(AFP)明显升高者1例,最高达930 IU/ml(0~6.05 IU/ml),术后最低降至7.73 IU/ml。15例患者总有效率为53.3%,其中贲门胃底癌总有效率为50.0%,胃窦癌总有效率为25.0%,胃体癌总有效率为80.0%。其中有2例患者在介入治疗后进行了根治性手术治疗。15例患者术后发生近期不良反应主要为恶心呕吐5例(33.3%),纳差6例(40.0%),腹痛腹胀4例(26.7%),低热2例(13.3%),白细胞减少1例(6.7%),均为轻度(1~2级),未发生重度(3~4级)不良反应。其中2例患者术后未发生明显不良反应。结论 经皮动脉化疗栓塞术治疗中晚期胃癌疗效确切,改善患者生活质量,使部分患者获得根治性手术切除的机会。Objective To observe the clinical efficacy of transcatheter arterial chemoembolization for advanced gastric cancer.Methods 15 patients with advanced gastric cancer were treated with transcatheter arterial chemoembolization.The treatment and follow-up,improvement of clinical symptoms,tumor markers,clinical efficacy,and occurrence of recent adverse reactions were analyzed.Results All 15 patients were operated successfully,and the mean interventional time was(118±45)min.Among the chemoembolized vessels,there were 6 cases of left gastric artery,2 cases of left gastric artery+right gastroomental artery,1 case of left gastric artery+right gastroomental artery+hepatic artery,2 cases of left gastric artery+left gastroomental artery+hepatic artery,3 cases of left gastric artery+gastroduodenal artery,and 1 case of left gastric artery+right gastroomental artery+right gastroomental artery.The mean length of hospital stay was(3.9±0.96)d.At the end of follow-up,5 of the 15 patients died,with a median survival period of 9 months,including 1 patient who survived for a maximum of 13 months;10 surviving patients had a mean survival period of more than 15.6 months.8 of the 12 patients with epigastric discomfort and epigastric pain were improved,2 cases of black stool were improved,1 case of positive fecal occult blood converted to negative,2 cases of acid reflux and heartburn were improved,1 case of dysphagia was significantly improved,and 4 cases of nausea and poor appetite were improved in 1 case.Most patients had increased appetite and reduced abdominal pain after treatment.Preoperative carcinoembryonic antigen(CEA)was elevated in 5 cases,of which 4 cases decreased postoperatively;preoperative glycoconjugate antigen 724(CA-724)was elevated in 5 cases,of which 4 cases decreased postoperatively;preoperative glycoconjugate antigen 125(CA-125)was elevated in 3 cases,all of which decreased postoperatively;preoperative alpha-fetoprotein(AFP)was significantly elevated in 1 case,up to 930 IU/ml(0-6.05 IU/ml),and decreased to a minimum

关 键 词：胃癌 经皮动脉化疗栓塞术 介入治疗 

分 类 号：R735.2[医药卫生—肿瘤]