摘要
目的探讨肠系膜上动脉灌注化疗治疗大网膜转移癌所致肠梗阻的治疗效果,为临床治疗恶性肠梗阻提供参考。方法 115例因大网膜转移癌患者存在腹痛、腹胀、无排气排便伴或不伴有恶心、呕吐等肠梗阻症状、腹部增强CT明确腹膜转移结节、腹部立位X线平片证实存在肠管扩张、肠内积气伴或不伴有液平等肠梗阻表现、腹部彩色多普勒超声明确腹水情况,随机分为动脉灌注化疗组58例和对照组57例,分别行肠系膜上动脉灌注化疗和内科姑息治疗。比较两组肠梗阻缓解时间、腹水消退情况、治疗效果及患者生存时间,并观察肠系膜上动脉灌注化疗的不良反应。结果动脉灌注化疗组患者腹胀及腹痛缓解时间、恢复排气时间及恢复排便时间均显著短于对照组(t=3.22、5.60、3.81,P<0.05),肠道通畅维持时间较对照组显著延长(t=9.05,P<0.01),腹水改善情况(75.0%)明显较对照组(33.3%)好(χ2=11.35,P<0.01)。动脉灌注化疗组肠梗阻治疗有效率为82.8%,显著高于对照组的42.1%(χ2=14.55,P<0.01);动脉灌注化疗组生存时间(5.3±1.2)个月,较对照组的(2.8±0.9)个月显著延长(P<0.01)。动脉灌注化疗组27例(46.6%)发生腹泻,血液系统及肝肾功能损害较小。结论采用肠系膜上动脉灌注化疗治疗大网膜转移癌所致肠梗阻疗效较好,能够在短期内缓解肠梗阻症状,不良反应少,可以延长患者的生存期。
Objective To explore the therapeutic effect of superior mesenteric arterial infusion chemotherapy in treating bowel obstruction caused by metastatic carcinoma of greater omentum so as to provide useful reference for clinical treatment of malignant bowel obstruction. Methods A total of 115 patients with metastatic carcinoma of greater omentum complicated by radiography-proved incomplete intestinal obstruction were enrolled in this study. Clinically, the patients complained of abdominal pain and distention, with or without defecation, nausea, vomiting and other symptoms of ileus. Enhanced abdominal CT scan revealed peritoneal metastatic nodules. Intestinal obstruction signs such as dilated intestinal loop, gas accumulation, air-fluid level, etc. were displayed on erect abdominal plain radiograph. Ascites was detected on ultrasonography examination. The patients were randomly divided into arterial infusion chemotherapy group（n = 58） and control group（n = 57）. Superior mesenteric arterial infusion chemotherapy was carried out in the patients of arterial infusion chemotherapy group, while palliative treatment was employed in the patients of the control group. The relieve time of bowel obstruction, regression of ascites, therapeutic effect and survival time of patients in both groups, as well as the toxic and side effects of superior mesenteric arterial infusion chemotherapy were determined, and the results were compared between the two groups. Results The remission time of abdominal distension and pain, the recovery time of anal exhaust and defecation in the arterial infusion chemotherapy group were significantly shorter than those in the control group（t = 3.22, t =5.60 and t = 3.81 respectively, P 0.05）. Compared with the control group, in the arterial infusion chemotherapy group the time of maintaining unobstructed intestinal tract was statistically longer（t = 9.05, P 0.01）, the improvement of ascites was more obvious（75.0% vs. 33.3%, χ2= 11.35, P 0.01）. The response rate of arterial infusion ch
出处
《介入放射学杂志》
CSCD
北大核心
2015年第2期130-133,共4页
Journal of Interventional Radiology
关键词
动脉灌注化疗
肠系膜上动脉
大网膜转移癌
恶性肠梗阻
arterial infusion chemotherapy
superior mesenteric artery
greater omentum metastatic carcinoma
malignant bowel obstruction
