动脉灌注化疗联合动脉栓塞治疗乳腺癌临床价值

Clinical Value of Arterial Infusion Chemotherapy Combined with Arterial Embolization in Treatment of Breast Cancer

目的探讨动脉灌注化疗联合动脉栓塞治疗乳腺癌的临床价值。方法经病理证实的乳腺癌患者45例,局麻后穿刺股动脉,全部采用Seldinger’s方法,将导管超选择、逐条送至乳腺癌的供血动脉内,经导管将经稀释的顺铂、表阿霉素、多西他赛、洛铂、卡铂、阿霉素等化疗药物二联或三联逐条、缓慢注入乳腺癌供血动脉内,再以不同规格和不同材质的栓塞剂逐条、逐层栓塞乳腺癌供血动脉。结果胸部疼痛等不适症状改善改善评分(86.52±4.23)分,肿物缩小评分(88.59±5.01)分,患者治疗配合评分(91.20±5.23)分。本组病例中1例患者出现坐起来活动时头晕并行走不稳,用改善微循环药物2d后缓解,4d后恢复至无任何异常感觉状态;1例患者出现手指末梢异位栓塞,中指指端皮肤发紫,疼痛,感觉迟钝。4例患者术后乳腺区域间断性疼痛明显,约24小时后缓解,其他患者均无明显不适。45例乳腺癌肿瘤患者出院后机体体质情况良好,可自行生活,短时间内无死亡、无复发情况,有2例患者肢体发生缺血与肿胀情况,通过后续相对应治疗,症状已好转。结论动脉灌注化疗、栓塞治疗对各期乳腺癌患者均有明显疗效。

Objective to explore clinical value of arterial infusion chemotherapy combined with arterial embolization in treatment of breast cancer.Methods 45 cases breast cancer patients pathologically diagnosed were treated with femoral artery puncture after local anesthesia.Catheters were sent to blood supply artery of breast cancer one by one with Seldinger’s method.Diluted cisplatin,epirubicin,docetaxel,loplatin,carboplatin,adriamycin and other chemotherapy drugs were injected into blood supply artery of breast cancer one by one through catheters embolic agents of same specification bigeminy or trigeminy slowly,and embolize blood supply arteries of breast cancer one by one,layer by layer with different materials.Results improvement scores of chest pain and other discomfort symptoms were(86.52±4.23),tumor reduction scores were(88.59±5.01),treatment cooperation scores were(91.20±5.23).In the group,one patient had dizziness and unsteady walking when sitting up and moving,relieved after 2 days with microcirculation improving drugs,and recovered to no abnormal sensory state after 4 days;one patient had ectopic embolism of finger endings,purplish skin of middle finger tip,with pain and slow sensation.After operation,4 cases had obvious breast region pains and relieved after about 24 hours.Other patients showed no obvious discomfort.45 cases breast cancer patients were in good physical condition after discharge,could live on their own,with no death or recurrence in short period.2 cases had limb ischemia and swelling.After follow-up treatment,symptoms were improved.Conclusion arterial infusion chemotherapy and embolization can achieve obvious effect for all stages of breast cancer.