低位直肠癌冷冻治疗临床初步分析  

Preliminary clinical study of cryotherapy for low rectal cancer

作　　者：陈杰[1] 武明胜[2] 李一金 李虎 向源楚 荣新奇[2] 彭健[1] Jie Chen;Mingsheng Wu;Yijin Li;Hu Li;Yuanchu Xiang;Xinqi Rong;Jian Peng(Department of Geriatric Surgery,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Anorectal Surgery,Affiliated Hospital of Hunan Provincial Research Institute of Traditional Chinese Medicine,Changsha 410006,China)

机构地区：[1]中南大学湘雅医院老年外科,长沙410008 [2]湖南省中医药研究院附属医院肛肠科,长沙410006

出　　处：《中华结直肠疾病电子杂志》2024年第6期494-498,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：湖南省自然科学基金项目(No.S2020JJKYLH0089)。

摘　　要：目的探讨低位直肠癌冷冻治疗的可行性、安全性以及有效性。方法回顾分析2018年1月~2024年5月于湖南省中医药研究院附属医院因各种原因不适合根治性手术或放化疗而接受冷冻治疗的85例低位直肠癌患者的临床资料,评估其在不同病理分期中的疗效,症状缓解情况及并发症等。结果冷冻治疗在改善患者症状上效果显著,85例纳入研究的患者中80例出现不同程度的症状,冷冻治疗后68例患者症状达到缓解。不同分期的直肠癌需要冷冻治疗的次数不同,T1~2期经过1~2次冷冻治疗能达到局部完全缓解,T3~4期的大部分需要3~4次冷冻治疗才能达到临床完全缓解的程度,甚至少量肿瘤经过4次冷冻治疗还不能完全缓解。并发症方面,85例患者治疗后出现9例出血、5例感染,其中1例出现肛周脓肿,70例患者出现不同程度的水肿,除了肛周脓肿行切开引流治疗,余并发症经对症保守治疗均缓解。结论低位直肠癌的冷冻治疗安全可行,短期内可以明显缓解直肠癌引起的症状,提高生活质量,可以作为不适合根治性手术的低位直肠癌的又一治疗选择。Objective To investigate the feasibility,safety,and efficacy of cryotherapy for low rectal cancer.Methods A retrospective analysis was conducted on the clinical data of 85 patients with low rectal cancer who underwent cryotherapy at the Affiliated Hospital of Hunan Provincial Research Institute of Traditional Chinese Medicine from January 2018 to May 2024.These patients were not suitable for radical surgery or radiotherapy and chemotherapy due to various reasons.The objective was to evaluate the efficacy,symptom relief status,and complications of cryotherapy in different pathological stages.Results Cryotherapy has achieved remarkable effects in improving patients’symptoms.Among the 85 patients included in the study,eighty presented with varying degrees of symptoms,and 68 of them experienced symptom relief after cryotherapy.The number of cryotherapy sessions required varied with the stage of rectal cancer.T1~2 stages typically required 1~2 sessions for complete local remission,while T3~4 stages mostly required 3~4 sessions to achieve clinical complete remission.A small number of tumors even did not achieve complete remission after 4 sessions.In terms of complications,among the 85 cases of cryotherapy for low rectal cancer,nine cases experienced bleeding,five cases had infections(including 1 case of perianal abscess),and 70 cases developed varying degrees of edema.Except for the perianal abscess,which required incision and drainage,all other complications were relieved with symptomatic conservative treatment.Conclusion Cryotherapy for low rectal cancer is safe and reliable.It can significantly alleviate symptoms caused by rectal cancer and improve quality of life in the short term,representing another viable treatment option besides conventional treatment methods for low rectal cancer that is not suitable for radical surgery.

关 键 词：直肠肿瘤 冷冻治疗 疗效分析 肿瘤分期 

分 类 号：R73[医药卫生—肿瘤]