雷替曲塞联合吉西他滨区域性灌注术治疗胰腺癌疗效观察

Efficacy Observation on Gemcitabine Combined with Gemcitabine in Treatment of Pancreatic Cancer with Regional Perfusion

目的：探讨雷替曲塞联合吉西他滨区域性灌注术治疗胰腺癌的疗效。方法：胰头癌患者将导管选至胃十二指肠动脉及肠系膜上动脉,胰体、尾癌患者将导管超选择至脾动脉,灌注经导管灌注雷替曲塞4 mg、吉西他滨1.2~1.6 g;对肝转移、梗阻性黄疸、十二指肠梗阻患者分别行肝动脉化疗栓塞术、经皮肝穿刺胆道引流术及胃十二指肠支架术。结果：全组病例半年生存率56.6%（17/30）,一年生存率26.7%（8/30）,中位生存期为9.6个月;术后疼痛缓解率63.3%（19/30）,疼痛无明显变化23.3%（7/30）,疼痛加重13.3%（4/30）;肝转移,梗阻性黄疸、十二指肠梗阻病例介入术后相关病灶稳定、临床表现消失,未出现相关并发症。结论：雷替曲塞联合吉西他滨区域性灌注治疗胰腺癌对改善患者症状,提高生存率疗效明显。

OBJECTIVE： To probe into the efficacy of gemcitabine combined with gemcitabine in treatment of 30 patients with pancreatic cancer by using regional perfusion method. METHODS： The duct of gastric duodenal artery and superior mesenteric artery were selected in patients with pancreatic head carcinoma,and of the body and tail ofpancreas cancer patients,the duct into the splenic artery was selected,with regional perfusion of emcitabine 4 mg,gemcitabine 1. 2 ~ 1. 6 g. Transcatheter arterial chemoembolization,percutaneous transhepatic cholangiography and drainage（ PTCD）,gastric and duodenal stenting were respectively conducted on hepatic metastasis,obstruction jaundice and duodenal obstruction patients. RESULTS： Of all cases,the half year survival rate was 56. 6%（ 17 /30）,one year survival rate was 26. 7%（ 8 /30）,the median survival time was 9. 6 months. The postoperative pain relief rate was 63. 3%（ 19 /30）,the rate of pain without any significant change was 23. 3%（ 7 /30）,and the rate of pain aggravation was 13. 3%（ 4 /30）. After the interventional operation in liver metastasis,obstructive jaundice and duodenal obstruction patients,the related lesion was stable,and the clinical manifestations disappeared without any complications. CONCLUSIONS： The efficacy of gemcitabine combined with gemcitabine in treatment of pancreatic cancer with regional perfusion is significant in improving the patients＇ symptoms and survival rate.