摘要
目的探讨彩超引导下经皮穿刺放射性125I粒子及5氟-尿嘧啶(5-FU)缓释剂植入治疗肝门区肿瘤的可行性及疗效观察。方法患者术前空腹,彩超引导选择合适进针路径,避开周围血管及胆管,采用单点多向、多点多向的方法力求125I粒子均匀分布,并在125I粒子间间隔植入5-FU缓释剂。术后1、2、6个月分别对患者进行超声及CT检查,根据肿瘤大小变化对疗效进行分级。将疗效分为4级,Ⅰ级:肿瘤缩小50%以上;Ⅱ级:肿瘤缩小25%~50%;Ⅲ级:肿瘤缩小25%以下;Ⅳ级:肿瘤大小无变化或增大。结果所有患者分别于术后1、2、6个月复查。1个月:Ⅰ级1例,Ⅱ级3例,Ⅲ级9例,Ⅳ级3例;2个月:Ⅰ级8例,Ⅱ级5例,Ⅲ级2例,Ⅳ级1例;6个月:Ⅰ级8例,Ⅱ级5例,Ⅲ级2例,Ⅳ级0例;术后5个月死亡1例。生存期5~18个月,中位生存期为11个月。结论彩超引导下经皮穿刺放射性125I粒子及5-FU缓释剂植入治疗肝门区肿瘤是一种安全、可靠且较为有效的治疗方法。
Objective To evaluate the feasibility and efficacy of ultrasound-guided percutaneous implantation of radioactive seed 125I and slow-released 5-FU in treating hilar hepatic tumor. Methods Patients fasting 12 hours before operation, choosing the best way into the target, avoiding significant blood vessel and bile duet, implanting 125I seeds alternating with 5-FU. Ultrasound and CT following examinations were performed 1,2 and 6 months after the therapy, respectively. According to the size of tumor,curative effects were graded as 4 grades：grade I ：the size of tumor reduced up 50% ;grade II ：the size of tumor reduced by 25 % - 50% ; grade Ⅲ ： the size of tumor reduced under 25 % ; grade Ⅳ ： the size of tumor did not reduce or increased. Results In 1 month,1 ease was classified as grade Ⅰ ,3 as grade Ⅱ ,9 eases as grade Ⅲ and 3 as grade Ⅳ ,respectively. In 2 months ,8 cases were classified as grade I ,5 as grade Ⅱ ,2 eases as grade Ⅲ and 1 as grade Ⅳ ,respectively. In 6 months,8 cases were classified as grade Ⅰ,5 as grade Ⅱ ,2 eases as grade Ⅲ and 0 as grade Ⅳ, 1 case died in 5 months after operation, respectively. Conclusions Ultrasound-guided radioaetive seed ^125I and slow-released 5-FU implanted was a safe,reliable and effective curative method for hilar hepatie tumor.
出处
《中华临床医师杂志（电子版）》
CAS
2008年第9期28-30,共3页
Chinese Journal of Clinicians(Electronic Edition)
关键词
超声检查
介入性
肝肿瘤
碘放射性同位素
近距离放射疗法
氟尿嘧啶
迟效制剂
Ultrasonography, interventional
Liver neoplasms
Iodine radioisotopes
Braehytberapy
Fluorouraeil
Delayed-action preprartions
