探讨经腹部超声引导宫腔管置入在不同分期宫颈癌患者三维腔内近距离放射治疗中的应用价值分析  

Application value analysis of the 3D intra cavitary brachytherapy of different phase of cervical cancer with TAUS

作　　者：李云[1] 鲁亮[1] 李勇[1] 罗素 陈玲 刘麒麟 韦泫妤 LI Yun;LU Liang;LI Yong;LUO Su;CHEN Ling;LIU Qilin;WEI Xuanyu(Department of Oncology,Guizhou Provincial People's Hospital,Guiyang,Guizhou 550000,China;Department of Ultrasound,Guizhou Provincial People's Hospital,Guiyang,Guizhou 550000,China)

机构地区：[1]贵州省人民医院肿瘤科,贵州贵阳550000 [2]贵州省人民医院超声科,贵州贵阳550000

出　　处：《影像研究与医学应用》2024年第10期37-39,43,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨经腹部超声(TAUS)引导宫腔管置入在ⅠB1~ⅣB期宫颈癌患者三维腔内近距离放射治疗(3D-ICB)中的临床应用及价值。方法:选取2023年6月—12月在贵州省人民医院收治的48例宫颈癌患者为研究对象,按宫腔管置入方法分为常规置入组(24例)和TAUS组(24例),每组均进行120次近距离放射治疗,经CT定位扫描验证两组患者的子宫隐匿穿孔率。结果:TAUS组与常规置入组比较,操作时长缩短(18.71 min vs 13.09 min,P=0.001),术中出血比例下降(19.16%vs 15.83%,P=0.611),CT扫描次数减少(121次vs 132次),隐匿性穿孔率下降(0.83%vs 5.83%,P=0.031),其中TAUS组与常规置入组各个分期穿孔率比较:ⅠB1~ⅡA2期(0.00%vs 0.00%);ⅡB~ⅢB期(0.00%vs 2.20%,P=0.343);ⅢC~ⅣB期(1.54%vs 10.00%,P=0.040)。结论:TAUS引导可以减少不同分期宫颈癌患者在3D-ICB宫腔管置入术中的时长,同时降低ⅢC~ⅣB期宫颈癌患者术后隐匿性穿孔率,为宫颈癌患者尤其是晚期患者的3D-ICB提供了一个更加安全有效的方法。Objective To investigate the clinical application and value of 3D intra cavity brachytherapy(3D-ICB)applicator placement with Trans abdominal ultrasonography(TAUS)assistance in stageⅠB1-ⅣB cervical cancer.Methods 48 cervical cancer patients admitted to Guizhou Provincial People's Hospital from June to December 2023 were selected as the study subjects.They were divided into a conventional insertion group(24 cases)and a TAUS group(24 cases)according to the method of uterine canal insertion.Each group underwent 120 rounds of close range radiation therapy,and the rate of hidden uterine perforation in both groups was verified by CT localization scanning.Results Compared with the conventional implantation group,the TAUS group had a shorter operating time(18.71 minutes vs 13.09 minutes,P=0.001),a decrease in intraoperative bleeding rate(19.16%vs 15.83%,P=0.611),a decrease in CT scans(121 vs 132),and a decrease in occult perforation rate(0.83%vs 5.83%,P=0.031).Among them,the perforation rates in different stages between TAUS group and conventional implantation group were compared:stagesⅠB1 toⅡA2(0.00%vs 0.00%).Stage II B-III B(0.00%vs 2.20%,P=0.343).Stage III C-IV B(1.54%vs 10.00%,P=0.040).Conclusion TAUS can reduce the placement time of 3D-ICB in cervical cancer with all phase,and reduce the rate of occult perforation in patients with phaseⅢC-ⅣB.TAUS provides a safer and more effective method for 3D-ICB in patients with cervical cancer,especially in patients with advanced phase.

关 键 词：宫颈癌 三维腔内近距离放射治疗 经腹超声引导 子宫穿孔 

分 类 号：R445.1[医药卫生—影像医学与核医学]