CAJ | 학술논문

目的初步评价高强度聚焦超声(HIFU)治疗胰腺癌的止痛作用和有效性.方法 29例不能手术的胰腺癌患者进行了HIFU治疗,通过症状、实验室检查和影像学变化等观察HIFU的治疗效果,同时比较全麻与镇静镇痛2种方式下HIFU治疗的剂量强度和效率的不同.结果治疗后68.2%(15/22)患者血清肿瘤标志物(Ca19-9)下降,疼痛缓解有效率为69.2%(18/26),影像学显示HIFU辐照靶区内组织呈凝固性坏死表现,1年生存率为23.1%,中位生存期为8.5个月.而全麻与镇静镇痛2种方式下HIFU治疗的剂量强度是一致的(P>0.05),但镇静镇痛方式下治疗的效率均要高于全麻方式(P<0.05).结论 HIFU 治疗能够有效地消融胰腺肿瘤和缓解疼痛,HIFU治疗胰腺癌更适合使用镇静镇痛方式.
목적 초보평개고강도취초초성(HIFU)치료이선암적지통작용화유효성.방법 29례불능수술적이선암환자진행료HIFU치료,통과증상、실험실검사화영상학변화등관찰HIFU적치료효과,동시비교전마여진정진통2충방식하HIFU치료적제량강도화효솔적불동.결과 치료후68.2%(15/22)환자혈청종류표지물(Ca19-9)하강,동통완해유효솔위69.2%(18/26),영상학현시HIFU복조파구내조직정응고성배사표현,1년생존솔위23.1%,중위생존기위8.5개월.이전마여진정진통2충방식하HIFU치료적제량강도시일치적(P>0.05),단진정진통방식하치료적효솔균요고우전마방식(P<0.05).결론 HIFU 치료능구유효지소융이선종류화완해동통,HIFU치료이선암경괄합사용진정진통방식.
Objective To evaluate the analgesic efficacy and effect of high-intensity focused ultrasound (HIFU) in the treatment of pancreatic cancer.Methods 29 patients with pancreatic cancer were treated by HIFU.According to some parameters,such as the clinical symptoms,the basis of main organs functional tests and imaging examinations to assess the efficacy of HIFU.Moreover,we compared dose intensity and efficiency of HIFU under general anesthesia or sedation-analgesia.Results 68.2% patients' (15/22) serum Ca19-9 decreased.The cancer pain was relieved in 69.2% patients(18/26).Coagulated-necrosis by CT/MRI examination was observed.1-year survival rate was 23.1%.Median survival time was 8.5 months.There was no obvious difference (P>0.05) in dose intensity of HIFU under two anesthetic methods.The efficiency of HIFU under sedation-analgesia was higher than that under general anesthesia (P<0.05).Conclusions Extracorporeal HIFU can effectively ablate pancreatic cancer and relieve pain.The mode sedation-analgesia is better applied for HIFU treatment with pancreatic cancer.