妇科恶性肿瘤介入治疗的临床应用与研究
摘要
目的:对妇科恶性肿瘤介入治疗的临床应用价值及并发症的研究。方法:对我院2003年11月至2006年3月,经彩超、病理等辅助检查均已证实为妇科恶性肿瘤患者68例(宫颈癌Ⅰb期2例、Ⅱa~Ⅱb期35例、Ⅲa期6例、Ⅲb期9例,卵巢癌Ⅲc8例,子宫内膜癌Ⅱ期6例,外阴肿瘤2例),采用Seldinger法,分别行子宫动脉、髂内动脉化疗栓塞或化疗灌注的治疗方法。结果:所有患者在术中DSA造影时,均可见在病变区域明显肿瘤染色,供血血管增粗、迂曲。部分患者并可见到肿瘤新生血管。其中19例患者1个月后复查证实肿瘤略有缩小,症状均有所好转,再次行介入治疗。45例患者术后2周左右行根治手术,4例患者出现外阴部皮肤软组织溃疡、坏死。总有效率可达94.2%,手术成功率达100%。结论:①术中DSA盆腔造影对判断病变范围、愈后及进一步明确诊断具有重要的临床价值。②可以提高手术切除率,对不能手术者对肿瘤也有一定的治疗作用。
Objective: To study the chinical application of interventionaltherapy in the trcatment of gynecologic malignancy and to discuss.The complications associated. .Method: sixty-eight historicallyconfirmed advanced gynecologic malignancy patients fromseptember 2003 to November 2006 March(corvial cancer provenbygynerologial examination 2 case wereat stageⅠb,35 in stageⅡa~Ⅱb,6 in stagsⅢa,9 in stagsⅢb. cancer includiny 8 oophcrogtnous. 5endomelrial cancer in vulnus).After receiviny internal iliac arterialinfusion chem. Ctherapy with, seldinger. Results:Before intemaliliac urterial infusion ohem otherapy internal iliac arteriog raphyshowed. Thay uterus artery was thickened and tortucus the newvessels. Appeared and the tumors. Were stained. 19 patients were.The clinical. Symptoms. Were improved signif cantly. And the sizeof tumors. Were more or less diminished even disappeared in allpatients. Of them. 45 patient received radical operation at thivd weekafter fivst. 4 patient developed seveve skin and effective rate was94.2%.The successful rate of operation was 100%. Conclusion:
Internal iliac arterioy raphy has practical sign if icance in assessingthe tum or size and evalnatiny the therapatic effects.The internal iliac.Arterial infusion chem. Otherapy can reduce the tum or size. Evenforthe patient who is not suitable for operation the reduction of the temor size still can enhance.
Objective: To study the chinical application of interventionaltherapy in the trcatment of gynecologic malignancy and to discuss.The complications associated. .Method: sixty-eight historicallyconfirmed advanced gynecologic malignancy patients fromseptember 2003 to November 2006 March(corvial cancer provenbygynerologial examination 2 case wereat stageⅠb,35 in stageⅡa~Ⅱb,6 in stagsⅢa,9 in stagsⅢb. cancer includiny 8 oophcrogtnous. 5endomelrial cancer in vulnus).After receiviny internal iliac arterialinfusion chem. Ctherapy with, seldinger. Results:Before intemaliliac urterial infusion ohem otherapy internal iliac arteriog raphyshowed. Thay uterus artery was thickened and tortucus the newvessels. Appeared and the tumors. Were stained. 19 patients were.The clinical. Symptoms. Were improved signif cantly. And the sizeof tumors. Were more or less diminished even disappeared in allpatients. Of them. 45 patient received radical operation at thivd weekafter fivst. 4 patient developed seveve skin and effective rate was94.2%.The successful rate of operation was 100%. Conclusion:
Internal iliac arterioy raphy has practical sign if icance in assessingthe tum or size and evalnatiny the therapatic effects.The internal iliac.Arterial infusion chem. Otherapy can reduce the tum or size. Evenforthe patient who is not suitable for operation the reduction of the temor size still can enhance.
引文
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3. 成文彩,蔡桂如,顾美皎等,髂内动脉化疗提高妇科恶性肿瘤疗效的探讨. 中华妇产科杂志,1992,27(5):270.
4. 陈正挺,陈一平,陈济铭等,介入治疗在妇科恶性肿瘤中临床应用.中国临床医学影像杂志,2003 年第 13 卷增刊.
5. Carlson JA,Litterst CL,Greanberg RA,et al. Platinum tissue concentrations following intra-arterialand In travenous CDDP II in new Zealand white rabbits.Am JOBtet Gynecol,1984;148(2):313.
6. Shingleton HM, Orr JW Jr. Cancer of the cervix. Philadephia: Lippincott, 1995.305-306.
7. Scarabelli C,Zarelli A,Callo A,etal. Multimodal treatmen surger yinpat entamithstage IIIB-IVA cencer,1995,76:1019.
8. 孙敏,张国玲等,介入化疗在妇癌中的应用。肿瘤,1996 年月(第 16 卷第 1 期).
9. Scldinger SL.Cathcter replaccment of nccdle in percutancous artcriograpy. Ncw tcchniquc. Acta Radiol,1953,39;368.
2. Worthingtorr Kisch RL,Popky GL,Hutchins FL.Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response. Radiology,1998,208(3) :625-629.
3. 成文彩,蔡桂如,顾美皎等,髂内动脉化疗提高妇科恶性肿瘤疗效的探讨. 中华妇产科杂志,1992,27(5):270.
4. 陈正挺,陈一平,陈济铭等,介入治疗在妇科恶性肿瘤中临床应用.中国临床医学影像杂志,2003 年第 13 卷增刊.
5. Carlson JA,Litterst CL,Greanberg RA,et al. Platinum tissue concentrations following intra-arterialand In travenous CDDP II in new Zealand white rabbits.Am JOBtet Gynecol,1984;148(2):313.
6. Shingleton HM, Orr JW Jr. Cancer of the cervix. Philadephia: Lippincott, 1995.305-306.
7. Scarabelli C,Zarelli A,Callo A,etal. Multimodal treatmen surger yinpat entamithstage IIIB-IVA cencer,1995,76:1019.
8. 孙敏,张国玲等,介入化疗在妇癌中的应用。肿瘤,1996 年月(第 16 卷第 1 期).
9. Scldinger SL.Cathcter replaccment of nccdle in percutancous artcriograpy. Ncw tcchniquc. Acta Radiol,1953,39;368.