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目的探讨超声引导125I放射性粒子植入治疗晚期胰腺癌的可行性和效果。方法术前根据肿块大小计算放射总剂量、粒子数量及间距。全麻后术中超声实时监视,均匀布针并植入粒子。术后超声及/或X线片确认植入部位及有无漏植。结果17例手术均获成功。术中超声清晰显示肿块,准确引导植入针的插入,成功监视粒子的植入,术后证实植入部位准确。术后1个月5例肿块消失,肿瘤缩小>50%7例,<50%5例。腹痛7例,3天后疼痛均消失。4例术后发热,2例腹水,2例各有1颗粒子迁徙到肝脏。所有患者术后1周左右均出现了胃肠道症状。除3例因多脏器功能衰竭死亡外,其余14例至2004年8月已存活2~26个月(平均10个月)。结论该项技术可行,具有明显姑息治疗作用。
Objective To investigate the feasibility and effectiveness of ultrasound-guided 125I radioactive seed implantation in the treatment of advanced pancreatic cancer. Methods According to the size of the tumor, the total dose of radiation, the number of particles and the distance were calculated before operation. After anesthesia intraoperative ultrasound real-time monitoring, uniform needle and implanted particles. Postoperative ultrasound and / or X-ray film to confirm the site of implantation and missed planting. Results 17 cases were successful. Intraoperative ultrasound showed a clear mass, accurately guide the insertion of the needle, the successful monitoring of the implantation of particles, postoperative confirmed the site of implantation. Five cases disappeared in one month after operation. The tumor size was reduced> 50% in 7 cases and <50% in 5 cases. Abdominal pain in 7 cases, 3 days after the pain has disappeared. Four cases had postoperative fever, two cases of ascites and two cases of one particle each migrated to the liver. Gastrointestinal symptoms occurred in all patients about 1 week after operation. In addition to three cases of multiple organ failure due to death, the remaining 14 cases to August 2004 has been living for 2 to 26 months (average 10 months). Conclusion This technique is feasible with obvious palliative effect.