贲门癌的综合介入治疗疗效观察

Clinical observation of combined interventional treatment on advanced cardiac carcinoma

目的观察经动脉化疗栓塞并内支架置放治疗中晚期贲门癌的临床效果。方法42例中晚期贲门癌患者除3例为临床诊断外其余均经内镜及病理学检查确诊。所有病例以Seldinger技术经股动脉穿刺插管,于肿瘤动脉内灌注化疗药物及栓塞剂并配合使用食管内支架置放术。灌注及栓塞以胃左动脉为主,少数辅以腹腔动脉、肝左动脉及左膈下动脉,所用栓塞剂为超液化碘油和明胶海绵颗粒。结果共行动脉灌注治疗143例次,平均3.4次/例,其中48例次加用碘油及明胶海绵颗粒栓塞。置放内支架47个。总有效率为88.1%(37/42),半年、1年及2年生存率分别为82.0%(35/42)、69.1%(29/42)及38.0%(16/42)。结论经动脉灌注化疗栓塞并内支架置放的综合介入疗法是中晚期贲门癌安全有效的治疗措施。

Objective To investigate the clinical value of combined interventional treatment on patients with advanced cardiac carcinoma. Methods Forty-two cases were included in this study, and the diagnosis was conformed by fibroscope and biopsy in all cases except 4 patients who were diagnosed according to clinical data and history. The catheter was introduced with Seldinger technique and the chemotherapeutic and embolic agents were infused into the target arteries. In addition, the esophageal stents were applied in all cases to alleviate the cardiac stenosis. The left gastric artery, celiac artery and left inferior subphrenic artery were the main target arteries into which the chemotherapeutic and embolic agents were infused. The embolic agents were composed of gelfoam granulation and lipiodol. Results In this study, 143 times of chemotherapeutic infusion and embolization were totally performed with an average time of 3.4. Forty-seven stents were planted. The symptom of dysphagia had been significantly remitted after stent planted. The total effective rate was 88.1%(37/42), and the survival rates of six month, one year and two year were 82.0%(35/42), 69.1%(29/42) and 38.0%(16/42), respectively. Conclusion In the treatment of advanced cardiac carcinoma, the method of combined interventional therapy can distinctively improve the effective rate and living quality of the patients.