术前介入治疗预防胃癌术后复发的疗效评价

The Effect of Preoperative Interventional Therapy on The Patients with Gastric Carcinoma

[目的]探讨术前介入治疗预防胃癌术后复发的临床意义。[方法]74例可根治性手术切除的胃癌患者分为两组,一组在根治性切除术前行经胃动脉灌注化疗(GAI)或经胃动脉灌注化疗栓塞(GAI+GAE),另一组直接行根治性切除术,观察介入治疗后患者的临床反应,比较两组患者术后相同时间复发率的差异。[结果]22例术前行GAI治疗的患者出现一过性恶心、呕吐,14例行GAI+GAE治疗的患者恶心、呕吐较重,有4例出现黑便,经保守治疗后症状消失;36例术前介入治疗的患者术后6、12、18、24个月的复发率分别为0、2.8%、11.1%、25.0%,38例直接行根治性切除术的患者分别为5.3%、10.5%、23.7%、39.5%,两组患者术后远期复发率存在显著差异。[结论]胃癌切除前行介入治疗(胃动脉灌注化疗或胃动脉灌注化疗栓塞)安全有效,对减少术后复发有显著的临床效果,值得推广。

To investigate the significance of pre-operative intervention against the gastric carcinoma recurrence after operation.Seventy-four cases with gastric carcinoma were divided into two groups,group A accepted gastric arterial influsion(GAI)or GAI+gastric arterial embolization(GAE)before radical gastrectomy,group B received radical gastrectomy only.The clinical response and the recurrent rate were compared between two groups.Twenty-two cases with chemotherapy(GAI)had transient nausea and vomiting.Fourteen patients represented nausea and vomiting more seriously after treatment of GAI+GAE.All patients recovered with conservative treatment.Thirty-six patients with pre-operative interventional therapy were recurrent following operation.The recurrent rates were0/36at6months,1/36at12months,4/36at18months,and9/36at24months,respectively.Of38cases group B,15cases were recurrent within two years following operation.The recurrence rates were2/38at6months,4/38at12months,9/38at18months,and15/38at24months.The recurrent rates between two groups were significantly different(P<0.05).[Conclusion]Pre-operative interventional therapy is safe and effective because it can significantly decrease recurrent rate after operation without severe complications.