胃镜下微波凝固治疗食管 贲门-胃底癌348例临床疗效评价

Clinical Evaluation of Effects of Microwave Coagulation Therapy under Gastroscope on 384 Cases of Advanced Esophageal Carcinoma and Cardia-fundus Gastricus Carcinoma

目的:评价微波凝固疗法治疗晚期食管癌和贲门-胃底癌348例的临床疗效。方法:选择晚期食管癌142例和晚期贲门-胃底癌206例为治疗组,选择放弃任何治疗的晚期食管癌和贲门-胃底癌102例为对照组,在胃镜下对治疗组瘤体进行微波凝固疗法,对照组仅进行支持对症治疗。结果:经1～2个疗程微波凝固疗法,治疗组有效率为92.82%,6、12、18和24个月累积生存率分别为97.0%、88.6%,、81.0%、72.1%。生存期为9.5±1.4个月,最长为3年。而对照组病情逐渐加重,6、8和12个月的累计生存率分别为55.0%、31.0%和0,生存期为3.5±0.67个月,且微波凝固治疗费用低、创伤和并发症少。结论:微波凝固疗法是治疗晚期食管癌和贲门-胃底癌较理想的方法之一,有利于缓解癌性狭窄,提高患者的生存时间.

Objective： To evaluate the clinical effects of microwave coagulation therapy on 384 cases of advanced esophageal carcinoma and advanced cardia-fundus gastricus carcinoma. Methods： One hundred and forty-two cases of advanced esophageal carcinoma and 206 cases of advanced cardia-fundus gastricus carcinoma were collected into the experimental group, and 102 cases of advanced esophageal carcinoma and advanced cardia-fundus gastricus carcinoma were collected into the control group. Patients in the experimental group received microwave coagulation therapy under gastroscope. Patients in the control group received supportive and symptomatic treatment. Results： The effective rate in the experiment group was 92.82% after one to two courses of microwave coagulation therapy. In the experimental group, the accumulative survival rates of 6 months, 12 months, 18 months and 24 months were 97.0%, 88.6%, 81.0% and 72.1%, repectively. The life span of patients in the experimental group was 9.5±1.4 months. In the control group, the accumulative survival rate of 6 months, 8 months and 12 months was 55.0%, 31% and zero, repectively. The life span of patients in the control group was 3.5±0.67 months. The microwave coagulation therapy cost less and caused less trauma and complications. Conclusion： The microwave coagulation therapy is a better method to treat advanced esophageal carcinoma and cardia-fundus gastricus carcinoma. This treatment can relieve carcinous stegnosis and increase patient survival.