药物明胶海绵颗粒在中晚期宫颈癌合并出血中的治疗价值

目的探讨药物明胶海绵颗粒在中晚期宫颈癌合并出血中的应用价值。方法 23例中晚期宫颈癌患者,采用Seldinger经皮穿刺方法灌注双侧子宫动脉或髂内动脉前干,再用化疗药物中的一种细胞周期特异性药物与明胶海绵颗粒充分混合栓塞子宫动脉或髂内动脉前干。术后观察止血情况、肿块大小变化及与周围组织的边界情况。结果 (1)23例宫颈癌合并出血患者出血在术后2～3天均得到完全控制,总有效率100%;(2)原发灶经双侧子宫动脉灌注化疗及药物明胶海绵栓塞后,所有病例临床症状均有明显改善;(3)2例行1次介入治疗后肿块完全消失;7例在介入治疗后1个月改行妇科手术宫旁浸润得到明显改善;其余14例在行2～3次介入治疗后9例获得了二次妇科手术机会,术中出血少,肿块周边界限清晰,另外5例介入前分期在Ⅲb以上,尽管介入治疗次数达到了2～3次,局部肿块得到了一定控制,但周边淋巴结控制不明显。结论对于中晚期宫颈癌合并出血患者,药物明胶海绵栓塞肿瘤的供血动脉治疗不仅可以起到直接阻断肿瘤血供,有利于出血部位止血,而且因明胶海绵的吸附作用,可以使药物长时间释放并作用于肿瘤细胞,达到双重治疗目的,不失为一种行之有效的治疗方法。

The Efficacy of Gelatin Sponge in Treatment of Advanced Cervical Cancers with Hemorrhage

Objective To evaluate the clinical efficacy of gelatin sponge in the treatment of persistent bleeding with cervical cancer.Methods 23 patients with advanced stage of cervical cancer were administered to pour into bilateral uterine artery or anterior trunk of internal iliac artery with seldinger technology,then embolized the arteries with a cell cycle specific drug which combined with gelatin sponge chips,and the site of bleeding and size of the tumor was observed.Results 1.The tumor bleeding was stopped after treatment in all cases,the overall response rate was 100%.2.After intervention chemotherapy and embolization,the symptoms of all the patients were obviously released.3.Masses of 2 cases were abolished after the treatment,the extent of the tumor invasion with para-uterine were reduced after the treatment,9 of 14 cases obtained the second chance of gynecology operation after 2-3 intervention therapy and the hemorrhage decreased,the margin of masses became clear.The other 5 cases in the stage IIIb,the lymphnodes were failed to control after 2-3 intervention therapy.Conclusion The drug gelatin sponge therapy not only can embolism the vessels,but also can prolong the drug in the tumor,which has the double effectiveness.