晚期胰腺癌双介入治疗及其疗效评价

Interventional therapy on advanced pancreatic carcinoma with intra arterial infusion chemotherapy and percutaneous transhepatic catheter drainage

目的 :探讨晚期胰腺癌和 /或合并阻塞性黄疸的介入治疗方法 ,对动脉灌注药物及经皮肝穿刺植入胆道支架的临床效果给予讨论。方法 :采用Seldinger技术经股动脉插管胰腺供血动脉内灌注化疗药物 ,经皮肝穿刺进行外引流或植入胆道支架进行内引流解除黄疸。结果 :12例病人疼痛症状明显改善 ,有 3例病人肿瘤体积有所缩小 ,行PTCD病人黄疸完全解除。结论 :动脉灌注化疗对缓解肿瘤生长速度和减少疼痛是一种可选择的有效方法 ,但对减少肿瘤体积、改善黄疸疗效有限。经皮肝穿刺胆汁外引流和植入胆道支架内引流可有效解除黄疸 ,改善症状 ,延长病人生存期。

Objective:To evaluate the efficacy of the intra arterial infusion chemotherapy and percutaneous transhepatic catheter drainage (PTCD) or stenting on advanced pancreatic carcinoma with or without obstructive jaundice.Methods:The intra arterial infusion chemotherapy via fermal artery by Seldinger's technique and percutaneous transhepatic catheter drainage (PTCD)were performed in 12 patients.Results:The pain was dramatically reduced in all cases,and the tumor size had decreased in 3 cases.The jaundice of patients was relieved after PTCD.Conclusions:intra arterial infusion chemotherapy is an effective method in retardation of the growth of the tumor and relief of the pain.PTCD with biliary stenting or external drainage is an effective procedure for relieving jaundice and subsequently palliating symptoms and prolonging survival time of the patients.