无水乙醇碘化油混合液在介入治疗腹膜后恶性肿瘤中的应用效果观察

Application effect observation of anhydrous ethanol iodized oil mixture in the interventional treatment of retroperitoneal malignant tumor

目的观察无水乙醇碘化油混合液在介入治疗腹膜后恶性肿瘤中的应用效果。方法回顾性分析2012年1月至2015年10月南阳市中心医院收治的23例腹膜后恶性肿瘤患者的临床资料,其中脂肪肉瘤5例、神经纤维肉瘤4例、平滑肌肉瘤7例、恶性间皮瘤4例、胃肠道间质瘤腹膜后转移3例。所有患者均予以CT导向下经皮细针穿刺并配合使用无水乙醇碘化油混合液治疗。观察混合液弥散效果、肿瘤变化情况以及疼痛缓解情况,观察治疗期间及治疗后并发症发生情况。结果 23例患者,穿刺注射治疗均顺利完成。CT扫描结果显示,M=100%:12例(52.17%);80%≤M<100%:7例(30.43%);50%≤M<80%:4例(17.39%);治疗前与治疗后1、3、6、12个月肿瘤最大径比较,差异均有统计学意义(P<0.05);治疗前VAS评分(6.50±1.03)分与治疗后1 d(5.22±1.15)分、1个月(1.27±1.12)分比较,差异均有统计学意义(P<0.05);治疗过程中出现穿刺区域灼烧痛10例(43.47%),术后出现恶心2例(4.65%),呕吐2例(4.65%),体温升高5例(11.63%),后均自行消失或经常规处理消失。无重度感染等严重并发症或难治性并发症。结论介入治疗中使用无水乙醇碘化油混合液,治疗腹膜后恶性肿瘤效果显著,能有效缩小肿瘤体积,缓解患者疼痛症状,并发症较少,安全性高。

Objective To observe the application effect of ethanol iodized oil mixture in the interventional treatment of retro- peritoneal malignant tumor. Methods Clinical data of 23 cases of retroperitoneal malignant tumor from January of 2012 to Octo- ber of 2015 in Nanyang Central Hospital were retrospective analyzed, including 5 cases of liposarcoma, 4 cases of neurofibrosar- coma, 7 cases of leiomyosarcoma, 4 cases of malignant mesothelioma and 3 cases of gastrointestinal stromal tumors with retroper- itoneal metastasis. All patients were treated using CT- guided percutaneous fine needle aspiration combined with absolute ethanol - iodized oil mixture. Mixed solution diffusion effect, tumor changes, pain relief and complications during and after treat- ment were statistically analyzed. Results For all the 23 patients, puncture injection was successfully completed. CT scan re- suits showed that, M = 100% ： 12 cases （52. 17%） ; 80% ≤ M 〈 100% ： 7 cases （30.43%） ; 50% ≤ M 〈 80% ： 4 cases （ 17.39% ）. Tumor sizes at 1, 3, 6 and 12 months before and after treatment were compared, and the differences were statisti- cally significant （ P 〈 0. 05 ）. The VAS score before treatment （ 6. 50 ± 1.03 ） was compared with that at 1 day （ 5.22 ± 1.15 ） and 1 month （ 1.27 ± 1.12） after treatment, and the difference was statistically significant （ P 〈 0. 05 ）. In the course of treat- ment, there were 10 cases of burning pain in the puncture area （43.47%） , 2 cases of postoperative nausea（4. 65% ）, 2 cases of vomiting （4. 65 % ）, 5 cases of body temperature increase （ 11.63 % ）, and then all the syndromes automatically disappeared or disappeared after conventional treatment. Conclusion Interventional therapy using ethanol mixture of iodine oil in the treatment of retroperitoneal malignant tumor gets good effects, which can effectively reduce tumor volume, relieve patients pain symptoms, reduce complications with high safety.