中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
4期
390-392
,共3页
杜义安%俞炎平%王实%程向东
杜義安%俞炎平%王實%程嚮東
두의안%유염평%왕실%정향동
胰腺肿瘤%胃肠内窥镜%碘放射性同位素%姑息疗法
胰腺腫瘤%胃腸內窺鏡%碘放射性同位素%姑息療法
이선종류%위장내규경%전방사성동위소%고식요법
Pancreatic neoplasms%Endoscopes,gastrointestinal%Iodine radioisotopes%Palliative care
目的 观察内镜联合125 Ⅰ粒子植入在老年胰腺癌患者姑息性手术治疗中的应用. 方法 选取难以进行胰腺癌根治手术的老年患者78例,随机分为观察组和对照组各39例,均采用内镜进行支架介入术,观察组额外采用CT或超声引导下的放射性粒子定向植入,比较两组患者的临床症状改善情况以及随访记录两组患者的生存期和并发症的发生情况. 结果 两组患者经治疗后临床症状均获得较大的改善,差异无统计学意义(x2 =0.06,P＞0.05),而观察组患者疼痛缓解情况明显优于对照组,疼痛发生率分别为46.2％和76.9％(x2=7.80,P＜0.05).两组患者平均生存期分别为(13.7±3.4)个月和(8.4±3.8)个月,观察组明显长于对照组,差异有统计学意义(t=3.73,P＜0.01),而远期生存率差异无统计学意义.两组患者术后并发症的发生率分别为10.3％和7.7％,差异无统计学意义(x2-0.15,P＞0.05). 结论 采用内镜联合125Ⅰ粒子植入治疗老年人胰腺癌,可有效缓解患者的临床症状,延长患者的生存期,减轻患者疼痛及减少并发症的发生,是晚期胰腺癌患者的有效治疗方法.
目的 觀察內鏡聯閤125 Ⅰ粒子植入在老年胰腺癌患者姑息性手術治療中的應用. 方法 選取難以進行胰腺癌根治手術的老年患者78例,隨機分為觀察組和對照組各39例,均採用內鏡進行支架介入術,觀察組額外採用CT或超聲引導下的放射性粒子定嚮植入,比較兩組患者的臨床癥狀改善情況以及隨訪記錄兩組患者的生存期和併髮癥的髮生情況. 結果 兩組患者經治療後臨床癥狀均穫得較大的改善,差異無統計學意義(x2 =0.06,P＞0.05),而觀察組患者疼痛緩解情況明顯優于對照組,疼痛髮生率分彆為46.2％和76.9％(x2=7.80,P＜0.05).兩組患者平均生存期分彆為(13.7±3.4)箇月和(8.4±3.8)箇月,觀察組明顯長于對照組,差異有統計學意義(t=3.73,P＜0.01),而遠期生存率差異無統計學意義.兩組患者術後併髮癥的髮生率分彆為10.3％和7.7％,差異無統計學意義(x2-0.15,P＞0.05). 結論 採用內鏡聯閤125Ⅰ粒子植入治療老年人胰腺癌,可有效緩解患者的臨床癥狀,延長患者的生存期,減輕患者疼痛及減少併髮癥的髮生,是晚期胰腺癌患者的有效治療方法.
목적 관찰내경연합125 Ⅰ입자식입재노년이선암환자고식성수술치료중적응용. 방법 선취난이진행이선암근치수술적노년환자78례,수궤분위관찰조화대조조각39례,균채용내경진행지가개입술,관찰조액외채용CT혹초성인도하적방사성입자정향식입,비교량조환자적림상증상개선정황이급수방기록량조환자적생존기화병발증적발생정황. 결과 량조환자경치료후림상증상균획득교대적개선,차이무통계학의의(x2 =0.06,P＞0.05),이관찰조환자동통완해정황명현우우대조조,동통발생솔분별위46.2％화76.9％(x2=7.80,P＜0.05).량조환자평균생존기분별위(13.7±3.4)개월화(8.4±3.8)개월,관찰조명현장우대조조,차이유통계학의의(t=3.73,P＜0.01),이원기생존솔차이무통계학의의.량조환자술후병발증적발생솔분별위10.3％화7.7％,차이무통계학의의(x2-0.15,P＞0.05). 결론 채용내경연합125Ⅰ입자식입치료노년인이선암,가유효완해환자적림상증상,연장환자적생존기,감경환자동통급감소병발증적발생,시만기이선암환자적유효치료방법.
Objective To observe the application of endoscopy combined with 125I seed implantation in the pancreatic cancer palliative surgery in elderly patients.Methods A total of 78 elderly patients with pancreatic cancer who can not be treated with radical operation were divided into observation group and control group (n=39 each group).All patients were treated with stent intervention.Patients in the ation group were treated with 125I seed implantation guided by CT or ultrasonangraphy additionally.The clinical symptoms were compared between groups.The survival time and complications of the patients were recorded during the follow-up.Results The clinical symptoms of patients in both two groups were greatly improved (x2 =0.06,P＞0.05).Compared with the control group,the pain remission was better and the incidence of pain caused by pancreatic cancer was lower in the observation group (46.2％ vs.76.9％,x2 =7.80,P＜0.05).There was a significant difference in the average of survival time between the observation group and control group [(13.7±3.4) months vs.(8.4±3.8) months,t=3.73,P＜0.01],but no statistical difference was found in the long-term survival rate between groups.There was no significant difference in the incidence of complications between the two groups (10.3％ vs.7.7％,x2=0.15,P＞0.05).Conclusions Endoscopy combined with 125Ⅰ seed implantation is an effective treatment for elderly patients with advanced pancreatic cancer,which can effectively relieve the clinical symptoms,proiong the survival time,reduce the pain and complications.
