中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2008年
6期
391-394
,共4页
唐喆%吴育连%方河清%许俊%莫国强%陈祥明%高顺良%李江涛%刘颖斌%王涌
唐喆%吳育連%方河清%許俊%莫國彊%陳祥明%高順良%李江濤%劉穎斌%王湧
당철%오육련%방하청%허준%막국강%진상명%고순량%리강도%류영빈%왕용
胰腺肿瘤%射频消融
胰腺腫瘤%射頻消融
이선종류%사빈소융
Pancreatic neoplasms%Radiofrequeney ablation
目的 探讨射频消融治疗胰腺癌的疗效和安全性.方法 对18例射频消融治疗胰腺癌的患者的临床资料进行回顾性分析.结果 本组11.1%(2/18)的胰体尾癌患者术后肿瘤标志物从数百降到正常,77.8%(14/18)的患者射频消融治疗后背部放射痛或腹痛减轻,其中6例疼痛完全消失.77.8%(14/18)的患者术后复查B超或CT后发现肿瘤有不同程度的缩小.全组死亡率为22.2%(4/18),其中3例表现为消化道出血,1例表现为急性肾功能衰竭.本组初期有16.7%(3/18)发生胰漏.随访有8例分别于术后1～8个月死亡.最长至今生存51个月.结论 射频消融结合必要的内引流治疗中晚期胰腺具有减轻疼痛的疗效.应用当今的射频模式治疗胰头肿瘤是危险的,治疗胰体尾肿瘤是安全的.通过胃管往十二指肠灌注冰水和改变射频机器参数可减少胰头肿瘤射频的并发症.
目的 探討射頻消融治療胰腺癌的療效和安全性.方法 對18例射頻消融治療胰腺癌的患者的臨床資料進行迴顧性分析.結果 本組11.1%(2/18)的胰體尾癌患者術後腫瘤標誌物從數百降到正常,77.8%(14/18)的患者射頻消融治療後揹部放射痛或腹痛減輕,其中6例疼痛完全消失.77.8%(14/18)的患者術後複查B超或CT後髮現腫瘤有不同程度的縮小.全組死亡率為22.2%(4/18),其中3例錶現為消化道齣血,1例錶現為急性腎功能衰竭.本組初期有16.7%(3/18)髮生胰漏.隨訪有8例分彆于術後1～8箇月死亡.最長至今生存51箇月.結論 射頻消融結閤必要的內引流治療中晚期胰腺具有減輕疼痛的療效.應用噹今的射頻模式治療胰頭腫瘤是危險的,治療胰體尾腫瘤是安全的.通過胃管往十二指腸灌註冰水和改變射頻機器參數可減少胰頭腫瘤射頻的併髮癥.
목적 탐토사빈소융치료이선암적료효화안전성.방법 대18례사빈소융치료이선암적환자적림상자료진행회고성분석.결과 본조11.1%(2/18)적이체미암환자술후종류표지물종수백강도정상,77.8%(14/18)적환자사빈소융치료후배부방사통혹복통감경,기중6례동통완전소실.77.8%(14/18)적환자술후복사B초혹CT후발현종류유불동정도적축소.전조사망솔위22.2%(4/18),기중3례표현위소화도출혈,1례표현위급성신공능쇠갈.본조초기유16.7%(3/18)발생이루.수방유8례분별우술후1～8개월사망.최장지금생존51개월.결론 사빈소융결합필요적내인류치료중만기이선구유감경동통적료효.응용당금적사빈모식치료이두종류시위험적,치료이체미종류시안전적.통과위관왕십이지장관주빙수화개변사빈궤기삼수가감소이두종류사빈적병발증.
Objecfive To explore the effects of treatment of unresectable pancreatic tumors by radiofrequency ablation(RFA)with"cool-tip needle".Methods 18 patients with unresectable pancreatic tumors,8 with pancreatic head carcinoma and 10 with pancreatic body and tail carcinomas,12 males and 6females,aged 66.2,underwent RFA under laparotomy for 3 times and simultaneous infusion of iced normal saline.The clinical data were retrospectively analyzed.Results The level of CA19-9,a tumor marker,returned to normal after RF in 2 patients.Back pain was alleviated in 14 patients.B mode ultrasonography or CT examination showed decrease of tumor volume in 14 patients after RF.Pancreatic fistula occurred in 3 patients(16.7%)and then healed smoothly in 7～10 days with after routine abdominal drainage.The mortality was 22.2%(4/18).In the 4 death cases,tumors were all located in the pancreatic head;three patients died suddenly of massive gastrointestinal hemorrhage at Days 4,30,and 40 days postoperative respectivelyafter RF and the other patient died of acute renal failure at Day 2 postoperatiVedays after RF.8patients died 1～8 months after RF.After 51 months,1 patient still survived.Conclusion RFA is effective in relicving the back pain for in unresectable pancreatic tumor patientsis efficiently relieving the back pain.Standard use of cool-tip RFA is dangerous for pancreatic head tumor carcinoma close to portal vein,but safe for those located in the body and tail of the pancreas.Making the Infusion of icedcooling-water flow via a gastric tube into the duodenum and changing change of the parameters of the RF system can reduce the associated complications.
