实用癌症杂志
實用癌癥雜誌
실용암증잡지
The Practical Journal of Cancer
2015年
10期
1487-1489
,共3页
胰腺癌%射频消融术%胰漏%消化道出血%热疗%血淀粉酶
胰腺癌%射頻消融術%胰漏%消化道齣血%熱療%血澱粉酶
이선암%사빈소융술%이루%소화도출혈%열료%혈정분매
Pancreatic cancer%Radiofrequency ablation%Pancreatic leakage%Gastrointestinal bleeding%Hyperthermia%Se-rum amylase
目的:探讨最佳支持治疗晚期胰腺癌的安全性和可行性。方法选取晚期胰腺癌患者为研究对象,整理分析其临床资料,予以最佳支持治疗,对有梗阻或黄疸的患者应用射频消融术以及对症止痛治疗,观察患者术后疗效、并发症、生存等情况。结果患者术前、术后1~7天血糖的变化比较,采用方差分析,P<0.05;患者术后血糖由于应激的原因,术后第1、2天血糖有升高趋势,以后血糖逐渐下降,术前和术后第7天血糖比较,P>0.05,术前术后无差异。患者术前、术后1~7天血淀粉酶值的变化比较,采用方差分析,P<0.05。患者引流液淀粉酶值的变化比较,采用方差分析,P<0.05,腹腔引流液有降低的趋势,术后第1天最多450 ml。拔管时间7~30天,中位拔管时间9.5天。肿瘤标志物CA199由(721.4±315.3)降至(184.2±290.7),采用t检验,P<0.05,差异有统计学意义;患者疼痛分数由(5.5±1.81)降至(1.63±0.86),差异有显著意义,P<0.05;各种程度的疼痛也明显降低,采用秩和检验,差异有统计学意义,P<0.05。术后患者发生胰瘘、胆瘘、消化道出血各1例,发生广泛转移2例。术后共死亡4例,其中死于消化道出血、腹腔内严重感染各1例,死于全身广泛转移后多脏器功能衰竭2例;余28例均存活6个月以上,最长1例已存活15个月。结论射频消融术治疗晚期胰腺癌可行且安全,近期治疗效果尚可,但远期治疗效果欠佳。
目的:探討最佳支持治療晚期胰腺癌的安全性和可行性。方法選取晚期胰腺癌患者為研究對象,整理分析其臨床資料,予以最佳支持治療,對有梗阻或黃疸的患者應用射頻消融術以及對癥止痛治療,觀察患者術後療效、併髮癥、生存等情況。結果患者術前、術後1~7天血糖的變化比較,採用方差分析,P<0.05;患者術後血糖由于應激的原因,術後第1、2天血糖有升高趨勢,以後血糖逐漸下降,術前和術後第7天血糖比較,P>0.05,術前術後無差異。患者術前、術後1~7天血澱粉酶值的變化比較,採用方差分析,P<0.05。患者引流液澱粉酶值的變化比較,採用方差分析,P<0.05,腹腔引流液有降低的趨勢,術後第1天最多450 ml。拔管時間7~30天,中位拔管時間9.5天。腫瘤標誌物CA199由(721.4±315.3)降至(184.2±290.7),採用t檢驗,P<0.05,差異有統計學意義;患者疼痛分數由(5.5±1.81)降至(1.63±0.86),差異有顯著意義,P<0.05;各種程度的疼痛也明顯降低,採用秩和檢驗,差異有統計學意義,P<0.05。術後患者髮生胰瘺、膽瘺、消化道齣血各1例,髮生廣汎轉移2例。術後共死亡4例,其中死于消化道齣血、腹腔內嚴重感染各1例,死于全身廣汎轉移後多髒器功能衰竭2例;餘28例均存活6箇月以上,最長1例已存活15箇月。結論射頻消融術治療晚期胰腺癌可行且安全,近期治療效果尚可,但遠期治療效果欠佳。
목적:탐토최가지지치료만기이선암적안전성화가행성。방법선취만기이선암환자위연구대상,정리분석기림상자료,여이최가지지치료,대유경조혹황달적환자응용사빈소융술이급대증지통치료,관찰환자술후료효、병발증、생존등정황。결과환자술전、술후1~7천혈당적변화비교,채용방차분석,P<0.05;환자술후혈당유우응격적원인,술후제1、2천혈당유승고추세,이후혈당축점하강,술전화술후제7천혈당비교,P>0.05,술전술후무차이。환자술전、술후1~7천혈정분매치적변화비교,채용방차분석,P<0.05。환자인류액정분매치적변화비교,채용방차분석,P<0.05,복강인류액유강저적추세,술후제1천최다450 ml。발관시간7~30천,중위발관시간9.5천。종류표지물CA199유(721.4±315.3)강지(184.2±290.7),채용t검험,P<0.05,차이유통계학의의;환자동통분수유(5.5±1.81)강지(1.63±0.86),차이유현저의의,P<0.05;각충정도적동통야명현강저,채용질화검험,차이유통계학의의,P<0.05。술후환자발생이루、담루、소화도출혈각1례,발생엄범전이2례。술후공사망4례,기중사우소화도출혈、복강내엄중감염각1례,사우전신엄범전이후다장기공능쇠갈2례;여28례균존활6개월이상,최장1례이존활15개월。결론사빈소융술치료만기이선암가행차안전,근기치료효과상가,단원기치료효과흠가。
Objective To investigate the safety and feasibility of the best supportive care for advanced pancreatic canc -er.Methods Patients with advanced pancreatic cancer were selected for the study ,clinical data were analyzed ,best supportive care were selected for patients with obstructive jaundice or radiofrequency ablation and symptomatic treatment of pain ,postopera-tive complications and survival of patients were observed .Results Preoperative ,postoperative changes in blood sugar 1~7 days were compared using analysis of variance ,P<0.05,postoperative blood glucose in patients due to the stress of reasons ,the first and second postoperative blood glucose tended to increase after glucose decreased ,preoperative and postoperative 7 days of blood glucose,P>0.05,there had no significant difference .Preoperative,postoperative changes in the value of serum amylase 1~7 days were compared using analysis of variance ,P<0.05.Changes in the patient drainage fluid amylase compared using analysis of va -riance,P<0.05,peritoneal fluid drainage has decreased postoperative day 1 up to 450 ml.Extubation time of 7~30 days,with a median time of 9.5 days of extubation.CA199 tumor marker dropped from (721.4 ±315.3) to (184.2 ±290.7),using the t test,P<0.05,there had significant difference;patient pain scores fell by (5.5 ±1.81)、(1.63 ±0.86),P<0.05,significant difference;various the degree of pain was significantly reduced ,by rank sum test,P<0.05,the difference was significant .Postop-erative pancreatic fistula ,biliary fistula,gastrointestinal bleeding in 1 case,the occurrence of widespread metastatic 2 cases,4 pa-tients died of gastrointestinal bleeding ,severe intra-abdominal infection in 1 case,died of extensive metastasis after 2 cases of mul-tiple organ failure.More than 28 cases were alive 6 months or more,the longest 1 case had survived 15 months.Conclusion Ra-diofrequency ablation therapy for patients with advanced pancreatic cancer is feasible and safe ,the short-term efficacy is accepta-ble,but long-term efficacy is poor .