CT引导下纳米刀消融治疗局部进展期胰腺癌的临床效果

Clinical effect of CT-guided irreversible electroporation on locally advanced pancreatic cancer

目的分析CT引导下纳米刀消融治疗局部进展期胰腺癌的临床疗效。方法抽取2017年1至2021年1月就诊于郑州大学第五附属医院的82例局部进展期胰腺癌患者为研究对象,其中行CT引导下纳米刀消融术(IRE)的44例患者为IRE组,行CT引导下射频消融术(RFA)的38例患者为RFA组。比较两组手术时间、术中出血量、住院时间,经腹部CT测量治疗前后的肿瘤长径。术前、术后3 d及术后1个月检测两组血清糖类抗原19-9(CA19-9)和血清淀粉酶水平。术后1个月采用增强CT/磁共振成像(MRI)扫描观察病灶消融区情况。结果IRE组手术时间短于RFA组,术中出血量少于RFA组(P<0.05)。术后3 d及1个月,IRE组患者血清CA19-9和血清淀粉酶水平均低于RFA组(P均<0.05)。影像学结果显示,两组患者病灶未见强化。IRE组术后并发症发生率(47.72%,21/44)与RFA组(57.89%,22/38)比较差异未见统计学意义(P>0.05)。结论CT引导下IRE对局部进展期胰腺癌治疗显示出优越的临床疗效,患者预后良好。

Objective To analyze the clinical curative effect of computed tomography(CT)-guided irreversible electroporation(IRE)on locally advanced pancreatic cancer.Methods A total of 82 patients with locally advanced pancreatic cancer treated in the Fifth Affiliated Hospital of Zhengzhou University from January 2017 to January 2021 were selected as research objects.Among them,44 cases undergoing CT-guided IRE were allocated into IRE group,and 38 cases undergoing CT-guided radiofrequency ablation(RFA)were allocated into RFA group.The operation time,intraoperative blood loss,hospital stay of the two groups were comapred.The major diameter of tumor were detected by CT before and after treatment.The carbohydrate antigen 19-9(CA19-9)and amylase of the two groups were detected before treatment,3 days after treatment and 1 month after treatment.And the radiation region of lesion were observed by enhanced CT/magnetic resonance imaging(MRI)scanning 1 month after treatment.Results The operation time in IRE group was significantly shorter than that in RFA group,and intraoperative blood loss was significantly less than that in RFA group(P<0.05).Three days and 1 month after surgery,levels of serum CA19-9 and amylase in IRE group were significantly lower than those in RFA group(all P<0.05).The imaging results showed that there was no lesions enhancement in either group.There was no significant difference in incidence of postoperative complications between IRE group(47.72%,21/44)and RFA group(57.89%,22/38),P>0.05.Conclusions The effect of CT-guided IRE is significant on pancreatic cancer,with good prognosis.