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目的使用不可逆电穿孔(IRE)消融技术治疗不可手术切除性局部进展胰腺癌,观察该技术治疗胰腺癌的安全性和疗效。方法前瞻性观察IRE消融术后30 d内不良反应并按照m RECIST标准评价术后(30±7)d客观疗效。结果共12例患者接受治疗,IRE手术均顺利完成,术后30 d内不良反应有穿刺点疼痛(5例,占41.7%)、恶心呕吐(3例,占25.0%)、咳嗽、术后低血糖、低钾血症、胃壁和十二指肠水肿各2例,占16.7%、胃潴留、发热及胸闷气促各1例,8.3%,经对症治疗后好转,未见治疗相关性大出血、胆漏或胰漏等严重并发症。术后24 h、7 d血液淀粉酶与术前相比,差异无统计学意义(P>0.05)。术后(30±7)d评价效果:完全缓解(CR)1例,部分缓解(PR)9例,稳定(SD)2例,肿瘤缓解率(CR+PR)为83.3%。结论IRE消融治疗不可手术切除性胰腺癌,不良反应轻,安全性高,近期疗效显著。远期疗效有待进一步观察。
Objective To investigate the safety and efficacy of this technique in the treatment of pancreatic cancer with unresectable local advancement using irreversible electroporation (IRE) ablation technique. Methods Adverse reactions within 30 days after IRE ablation were prospectively observed and the objective therapeutic effect was evaluated according to m RECIST criteria after 30 ± 7 days. Results A total of 12 patients were treated successfully. All patients underwent IRE successfully. Postoperatively, adverse reactions included puncture pain (5 cases, 41.7%), nausea and vomiting (3 cases, 25.0%), cough and postoperative low Blood glucose, hypokalemia, stomach wall and duodenal edema in 2 cases, accounting for 16.7%, gastric retention, fever and chest tightness, irritation in 1 case, 8.3%, after symptomatic improvement, no treatment-related bleeding, Bile leakage or pancreatic leakage and other serious complications. Blood amylase at 24 h and 7 d after operation showed no significant difference (P> 0.05). Postoperatively, the effect of CR was evaluated in 1 case of complete remission (CR), 9 cases of partial remission (PR) and 2 cases of stable (SD). The CR + PR was 83.3%. Conclusion IRE ablation of unresectable pancreatic cancer, mild adverse reactions, high safety, the recent significant effect. Long-term efficacy needs further observation.