选择性髂内动脉插管灌注对盆腔恶性肿瘤介入性治疗的手术研究与探索

本文旨在探讨盆腔恶性肿瘤的介入性治疗问题。对45例患有盆腔恶性肿瘤的患者,采用Seldinger法,经双侧股动脉插管,先端选择性导入对侧髂内动脉;或一侧导入肠系膜下动脉,另侧导入髂内动脉,留置导管12小时,使用突击剂量持续灌注化疗药物。并经手术、B超、CT、内窥镜及指检等方法进行化疗前后的对比观察。结果:其中病灶消失持续1个月以上者9例、病灶缩小50％以上并持续超过一个月者23例、缩小不足50％且增大未达25％者9例、增大超过25％以上者4例,总有效率为71.1％。10例患者出现了脱发及皮肤色素沉着,1例患者出现下肢动脉栓塞,10例出现了不同程度的消化道反应等。结论:本法损伤小,操作简便安全,可多次重复术式:选择性强,药效持久均衡且毒副作用小;可提高手术切除率,也为不能手术的癌肿提供一种较理想的治疗手段。

Interventional treatment of pelvic malignancy

Continuous infusion of anticancer in 12 hours period was performed viabilateral internal iliac artery intubation in 45 patients with pelvic malignant tumor . The head of the cannulas was inserted into contraliteral internal iliac artery or one into inferior mesenteric artery and another into internal iliacaretry. Comparative observation before and after chemotherapy was made by means of ulrasonography,endoscopy,computed tomography,surgery and rectal touch. of the 45 patients studied , the tumor showed complete response (CR) to the therapy in nine patients partial response (PR) in twenty three, minorresponse in nine, and no change (NO in four, with the response rate (CR PR)of 71.7% (32 of 45) . There were no serious side effects except for baldness and pigmentation in ten patients emboiization of lower extremity in one and symptom of digestive tract in ten. Thus, the mew method is relatively simple and safe and can inctease survival and resection rate, dectease the side effect of drugs, and salo provide a therapy for inoperable cases.