不可逆电穿孔消融治疗不可切除性胰腺癌对心肌酶的影响

Effect of irreversible electroporation ablation on myocardial enzymes in patients with unresectable pancreatic cancer

目的 通过观察接受不可逆电穿孔(IRE)消融治疗的不可切除性胰腺癌患者心肌酶水平变化,为IRE消融治疗胰腺癌的术前评估及术后安全性判断提供一定的临床参考。方法 回顾性分析2016年10月至2021年10月广州复大肿瘤医院收治的50例不可切除性胰腺癌患者,分为原位消融组(胰腺癌合并/不合并肝转移瘤,采用IRE原位消融胰腺癌,23例)与合并消融组(胰腺癌合并肝转移瘤,进行IRE消融,27例)。比较IRE消融术前、术后心肌酶水平的变化,并比较原位消融组与合并消融组患者术后心肌酶水平。结果 与术前相比,两组术后当天心肌酶水平均显著升高(P<0.001),且两组相比,α-羟丁酸脱氢酶、乳酸脱氢酶及天门冬氨酸氨基转移酶差异有统计学意义(P<0.05),术后3 d两组心肌酶水平呈现下降趋势。结论 IRE消融治疗的胰腺癌患者心肌酶水平呈一过性升高,IRE消融安全性较好。

Objective To observe the changes of myocardial enzyme levels in the patients with unresectable pancreatic cancer treated by irreversible electroporation(IRE) ablation so as to provide some clinical reference for the preoperative evaluation and postoperative safety of IRE in the treatment of pancreatic cancer.Methods Fifty patients with unresectable pancreatic cancer in the Guangzhou Fuda Tumor Hospital from October 2016 to October 2021 were retrospectively analyzed, and divided into the ablation in situ group(pancreatic cancer with or without liver metastasis tumor, adopting IRE ablation in situ for pancreatic tumors, 23 cases) and the combined ablation group(pancreatic cancer complicating liver metastasis tumor, conducting IRE ablation, 27 cases).The change of myocardial enzyme levels were compared between before and after IRE ablation and the postoperative myocardial enzyme levels were compared between the in situ ablation group and the combined ablation group.Results Compared with before operation, the levels of myocardial enzymes on the operation day in both groups were increased significantly(P<0.001),moreover in the comparison between the two groups, the differences in α-hydroxybutyrate dehydrogenase(HBDH),lactate dehydrogenase(LDH) and asparagine aminotransferase(AST) had statistical significance(P<0.05).The myocardial enzyme levels in the two groups showed a downward trend on postoperative 3 d.Conclusion In the patients with pancreatic cancer treated by IRE ablation, the myocardial enzyme levels show the transient increase, and IRE ablation has good safety.