经导管动脉内介入治疗难治性鼻咽癌放疗后大出血的存活率及死亡率分析

Analyse on survival rate and mortality of massive hemorrhage after refractory nasopharyngeal carcinoma treated by transcatheter arterial intervention

目的研究经导管动脉内介入治疗难治性鼻咽癌放疗后大出血的存活率及死亡率。方法选择2013年1月~2016年1月于我院接受治疗的难治性鼻咽癌放疗后大出血患者24例作为研究对象,对所有患者进行经导管动脉内介入治疗,观察接受治疗后患者的存活率和死亡率。结果 24例患者从开始接受治疗到治疗结束共进行了32次经导管动脉内介入治疗,仅接受1次经导管动脉内介入治疗的患者有18例,接受2次经导管动脉内介入治疗的患者有4例,接受3次经导管动脉内介入治疗的患者有2例。截止到总结本次研究资料时,仍然存活的患者有14例,患者的存活率为58.33%,接受治疗后20天内因鼻腔再次发生大出血导致死亡的患者有8例,接受治疗后40天内死亡的患者一共有10例,其中有两例患者死于全身感染和衰竭,患者的死亡率为41.67%。术后有9例患者出现复视、面目麻木、疼痛以及肢体肌力减弱等情况,对患者进行对症治疗后痊愈。结论对于难治性鼻咽癌放疗后大出血的患者,采用经导管动脉内介入治疗能够取得较好的治疗效果,虽然患者在接受治疗之后再次出现大出血以及并发症的概率比较高,但是在降低难治性鼻咽癌放疗后大出血患者的死亡率方面,效果还是值得肯定的。

Objective To study the survival rate of transcatheter arterial intervention and mortality in treatment of massive hemorrhage after radiotherapy for refractory nasopharyngeal carcinoma. Methods Twenty-four patients with massive hemorrhage after radiotherapy for refractory nasopharyngeal carcinoma were selected from January 2013 to January 2016 in our hospital.All patients were treated with transcatheter arterial intervention.The survival rate and mortality were observed. Results Twenty-four patients received 32 transcatheter arterial interventions from the beginning to the end of the treatment,18 patients received only one transcatheter arterial intervention,and 4 patients received two transcatheter arterial interventions,two patients received three transcatheter arterial interventions.By summing up the research data,there were 14 patients still alive,patients survival rate was 58.33%,within 20 days after treatment,there were 8 patients who died as a result of recurrent massive bleeding in the nasal cavity,10 patients died within 40 days after treatment,two of them died of systemic infection and exhaustion, and the mortality rate of the patients was 41.67%.There were 9 cases of dysphasia,facial numbness, pain and weakness of limb muscle strength after operation.The patients were cured after symptomatic treatment. Conclusion For patients with massive bleeding after radiotherapy for refractory nasopharyngeal carcinoma,transcatheter arterial interventional therapy can achieve better treatment effect.Although the probability of recurrence of bleeding and complications after treatment is high,the effect on reducing the mortality rate of patients with massive hemorrhage after radiotherapy for refractory nasopharyngeal carcinoma is worthy of recognition.