CAJ | 학술논문

目的：探讨进展期食管癌内镜下序贯治疗的疗效和序贯治疗方法。方法将240例中晚期食管癌患者分为试验组126例和对照组114例。试验组又分为A组（局部化疗药物注射＋普通金属支架置入）、B组（局部化疗药物注射＋碘-125粒子支架置入）和C组（射频治疗＋普通金属支架置入）；对照组分为D组（单纯局部化疗药物注射）、E组（单纯射频治疗）和F组（单纯普通金属支架置入）。观察各组3月、6月、1年、1.5年、2年生存率、生存质量及不良反应发生情况。结果试验组治疗结束后6月、1年、1.5年、2年生存率均高于对照组，其中A组与B组生存率差异无统计学意义，但均高于C组（P＜0.05）。试验组治疗结束后1、1.5、2年，患者总体健康状况、躯体功能、社会功能、情绪功能评分均高于对照组，A、B组评分高于C组，B组评分高于A组（ P＜0.05）。两组不良反应发生率比较差异无统计学意义，A、B组食管气管瘘与新增转移发生率明显低于其余各组，B组食管气管瘘与新增转移发生率低于A组（ P＜0.05）。结论内镜下序贯治疗中晚期食管癌，疗效显著，有临床推广应用价值。
목적：탐토진전기식관암내경하서관치료적료효화서관치료방법。방법장240례중만기식관암환자분위시험조126례화대조조114례。시험조우분위A조（국부화료약물주사＋보통금속지가치입）、B조（국부화료약물주사＋전-125입자지가치입）화C조（사빈치료＋보통금속지가치입）；대조조분위D조（단순국부화료약물주사）、E조（단순사빈치료）화F조（단순보통금속지가치입）。관찰각조3월、6월、1년、1.5년、2년생존솔、생존질량급불량반응발생정황。결과시험조치료결속후6월、1년、1.5년、2년생존솔균고우대조조，기중A조여B조생존솔차이무통계학의의，단균고우C조（P＜0.05）。시험조치료결속후1、1.5、2년，환자총체건강상황、구체공능、사회공능、정서공능평분균고우대조조，A、B조평분고우C조，B조평분고우A조（ P＜0.05）。량조불량반응발생솔비교차이무통계학의의，A、B조식관기관루여신증전이발생솔명현저우기여각조，B조식관기관루여신증전이발생솔저우A조（ P＜0.05）。결론내경하서관치료중만기식관암，료효현저，유림상추엄응용개치。
Objective To explore the curative effect of an endoscopic sequential treatment for patients with advanced esopha -geal cancer .Methods Two hundred and forty patients with advanced esophageal carcinoma were randomly divided into experimental group (n =126) and control group (n =114).The experimental group was further divided into group A ,B and C.The group A was treated with local chemotherapy drug injection plus bare-metal stent The group B was treated with local chemotherapy drug injection plus iodine 125 particle stent ,while the group C was treated radiofrequency treatment plus bare-metal stent .The control group was further divided into group D ,E and F.The group D was treated with simple local chemotherapy drug injection .The group E was treated with pure radiofrequency treatment while the group F was treated with simple bare-metal stent.Survival rate in 3 months,6 months,1 year, 1.5 year and 2 years,quality of life and adverse reaction were compared among the groups .Results The survival rates after 6 months, 1 year,1.5 year and 2 year in the experimental group were higher than that in the control group .Although there was no significant difference between the group A and group B ,the survival rate of the two groups were significantly higher than that in the group C ( P<0.05 ) .In terms of quality of life ,overall health ,physical function ,social function ,and emotional function mean score in the experimen-tal group were all higher than that in the control group after treatment 1 year,1.5 year and 2 years The emotional function mean score of the group A and B were higher than that of the group C while the group B was in turn higher than the group A .No statistical differ-ence in incidence of adverse reactions was found between the experimental and control groups .The esophageal tracheal fistula and new transfer rates in the group A and B were significantly lower than that in other groups .Further,the metastatic rate in the group B was low-er than that in the group A ( P<0.05 ) .Conclusion The clinical efficiency of endoscopic sequential therapy in treatment of patients with advanced esophageal cancer is distinct .It has a clinical application value .