發(fā)布時(shí)間：2018-06-28 12:28

  本文選題：宮頸癌 + 新輔助化療��； 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：通過對(duì)比新輔助化療的全身靜脈化療和介入化療加栓塞術(shù)的臨床療效,探討子宮動(dòng)脈灌注化療加栓塞術(shù)在宮頸癌新輔助化療中的價(jià)值、其對(duì)患者施行宮頸癌根治性手術(shù)的影響、及其能否改善患者的生存率的遠(yuǎn)期療效。以圖幫助臨床醫(yī)師在臨床工作中根據(jù)患者的病情、經(jīng)濟(jì)條件及醫(yī)院技術(shù)設(shè)備等綜合評(píng)估,使用更科學(xué)和合理的新輔助化療方式,對(duì)提高宮頸癌患者手術(shù)的安全性及預(yù)后有很大的臨床意義。 方法：回顧性分析90例局部晚期宮頸癌患者的臨床資料,根據(jù)新輔助化療的不同途徑將其分組,其中術(shù)前行動(dòng)脈插管灌注化學(xué)治療加栓塞術(shù)(介入化療組)44例,術(shù)前行全身靜脈化學(xué)治療(全身化療組)46例。比較兩組的臨床療效、不良反應(yīng)、手術(shù)情況、病理學(xué)變化情況和遠(yuǎn)期療效。 結(jié)果：介入化療組和靜脈化療組的癌灶消退情況均較好,介入化療組的陰道流血緩解率(100%)較靜脈化療組(91.3%)的高,差異有統(tǒng)計(jì)學(xué)意義(P=0.001)；另外,靜脈化療組的手術(shù)術(shù)中出血量為(539.1±318.1)m1,介入化療組的為(342.7±157.7)m1,兩者差異亦有統(tǒng)計(jì)學(xué)意義(P=0.000)；兩組的腫瘤縮小情況、骨髓抑制情況、胃腸道反應(yīng)情況、手術(shù)間隔時(shí)間、手術(shù)時(shí)長(zhǎng)及術(shù)后病理變化情況均相近,差異無統(tǒng)計(jì)學(xué)意義(P0.05)；介入化療組3、5年生存率分別為89%、85%,復(fù)發(fā)率為15.9%；靜脈化療組的3、5年生存率分別為79%、79%,復(fù)發(fā)率為21.7%；差異無統(tǒng)計(jì)學(xué)意義(P均0.05)；兩組生存曲線無顯著性差異(P0.05)。 結(jié)論：兩種新輔助化療方法對(duì)治療宮頸癌均能較好的縮小癌灶,動(dòng)脈灌注化療加栓塞術(shù)能更好的緩解陰道流血,對(duì)避免術(shù)前貧血起到積極作用,且動(dòng)脈灌注化療加栓塞術(shù)能更好的減少術(shù)中出血量,提高手術(shù)的安全性。但對(duì)于遠(yuǎn)期療效來說,動(dòng)脈化療加栓塞術(shù)與全身靜脈化療相比,未能降低患者的復(fù)發(fā)率和提高患者的3、5年生存率。
[Abstract]:Objective: to compare the clinical effects of systemic intravenous chemotherapy with neoadjuvant chemotherapy and interventional chemotherapy combined with embolization, and to explore the value of uterine artery infusion chemotherapy plus embolization in neoadjuvant chemotherapy for cervical cancer. Its effect on patients with cervical cancer radical surgery, and can improve the long-term survival rate of patients. In order to help clinicians use more scientific and reasonable new adjuvant chemotherapy methods in clinical work according to the comprehensive assessment of the patient's condition, economic conditions and hospital technical equipment, It is of great clinical significance to improve the safety and prognosis of cervical cancer patients. Methods: the clinical data of 90 patients with locally advanced cervical cancer were analyzed retrospectively. According to the different ways of neoadjuvant chemotherapy, 44 patients were treated with preoperative arterial infusion chemotherapy plus embolization (interventional chemotherapy group). Before operation, 46 patients were treated with systemic intravenous chemotherapy (systemic chemotherapy group). The clinical effects, adverse reactions, surgical conditions, pathological changes and long-term outcomes were compared between the two groups. Results: the remission rate of vaginal bleeding in interventional chemotherapy group (100%) was higher than that in intravenous chemotherapy group (91.3%), the difference was statistically significant (P0. 001). The amount of intraoperative bleeding was (539.1 鹵318.1) ml in intravenous chemotherapy group and (342.7 鹵157.7) ml in interventional chemotherapy group (P < 0.01). The 3- and 5-year survival rates in the interventional chemotherapy group were 890.The recurrence rate was 15.90.The 3- and 5-year survival rates in the intravenous chemotherapy group were 790.The recurrence rate was 21.7. There was no significant difference in survival curve between the two groups (P0.05). Conclusion: the two new adjuvant chemotherapy methods can reduce the cancer focus of cervical cancer, arterial infusion chemotherapy and embolization can relieve vaginal bleeding better, and play a positive role in the prevention of preoperative anemia. Arterial infusion chemotherapy combined with embolization can reduce intraoperative bleeding and improve the safety of the operation. However, compared with systemic intravenous chemotherapy, arterial chemotherapy and embolization can not reduce the recurrence rate and improve the 3- and 5-year survival rate.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.33

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本文編號(hào)：2078001