【摘要】：目的:高強(qiáng)度聚焦超聲(H IFU)作為興起不久的一種非侵入性治療技術(shù),雖已投入多種實(shí)體腫瘤的治療且也取得一定療效,但很多醫(yī)生和患者對(duì)該治療方式的認(rèn)識(shí)仍很局限,我們希望通過分析結(jié)直腸癌肝轉(zhuǎn)移患者接受治療的情況,探討其在治療結(jié)直腸癌肝轉(zhuǎn)移中的安全性和有效性以及影響其預(yù)后的因素,從而探究其在治療結(jié)直腸癌肝轉(zhuǎn)移領(lǐng)域是否具有臨床價(jià)值和是否值得被推廣。資料和方法:回顧性分析2001年3月至2012年12月在重慶醫(yī)科大學(xué)附屬第二醫(yī)院HIFU腫瘤中心接受HIFU消融治療的39例結(jié)直腸癌肝轉(zhuǎn)移患者術(shù)前術(shù)后肝功、CEA和影像學(xué)檢查(CT或MRI)的變化情況,生存結(jié)果,以COX比例風(fēng)險(xiǎn)回歸模型確定影響預(yù)后的獨(dú)立因素。結(jié)果:1.39例結(jié)直腸癌肝轉(zhuǎn)移患者接受HIFU消融治療后ALT升高(P0.05),白蛋白下降(P0.05),總膽紅素變化不大(P0.05)。2.39例結(jié)直腸癌肝轉(zhuǎn)移患者接受HIFU消融治療后CEA值較術(shù)前降低(P0.05)。3.39例結(jié)直腸癌肝轉(zhuǎn)移患者接受HIFU消融治療后復(fù)查增強(qiáng)CT或MRI示:完全消融16例(41.0%),部分消融19例(48.7%),未消融4例(10.3%)。4.39例結(jié)直腸癌肝轉(zhuǎn)移患者(失訪3人)接受HIFU消融治療后的中位生存期為25個(gè)月,1、2、3、5年生存率為91.7%、55.6%、22.2%、5.6%。5.性別、年齡、原發(fā)腫瘤部位、是否有肝外轉(zhuǎn)移、病灶數(shù)目以及病灶消融范圍對(duì)預(yù)后影響均不顯著(P0.05)。結(jié)論:1.對(duì)于不能手術(shù)切除或不愿行手術(shù)切除的結(jié)直腸癌肝轉(zhuǎn)移患者,高強(qiáng)度聚焦超聲(HIFU)是一種可選擇的安全且有效的治療方式。2.雖然在此研究中,性別、年齡、原發(fā)腫瘤部位、有無肝外轉(zhuǎn)移、病灶數(shù)目以及病灶消融范圍均對(duì)患者預(yù)后無影響,但其還需行進(jìn)一步的前瞻的研究。
[Abstract]:Objective: high intensity focused ultrasound (HIFU) (H IFU) is a new non-invasive treatment technique. Although it has been used in the treatment of various solid tumors and has achieved certain curative effect, many doctors and patients still have very limited understanding of the treatment method. We hope to investigate the safety and efficacy of the treatment of colorectal cancer with liver metastasis and the prognostic factors by analyzing the status of treatment of patients with liver metastasis from colorectal cancer. To explore whether it has clinical value and whether it is worth popularizing in the field of liver metastasis of colorectal cancer. Materials and methods: from March 2001 to December 2012, 39 patients with liver metastases from colorectal cancer receiving HIFU ablation at HIFU tumor Center, second affiliated Hospital of Chongqing Medical University, were retrospectively analyzed. Changes in (CT or MRI), COX proportional risk regression model was used to determine the independent prognostic factors. Results after HIFU ablation, ALT increased (P0.05), albumin decreased (P0.05), and total bilirubin did not change significantly in 1.39 patients with liver metastasis of colorectal cancer after HIFU ablation (P0.05). After HIFU ablation, CT or MRI showed that 16 cases (41.0%) were completely ablated, 19 cases (48.7%) were partially ablated, and 4 cases (10.3%) were not ablated. 4.39 cases of liver metastasis from colorectal cancer (3 missing persons) received HIFU ablation. The survival time was 25 months and the 5-year survival rate was 91.7 and 55.6 respectively. Sex, age, primary tumor location, whether there were extrahepatic metastasis, the number of lesions and the extent of ablation had no significant effect on the prognosis (P0.05). Conclusion 1. High intensity focused ultrasound (HIFU) is an alternative safe and effective treatment for patients with liver metastases from colorectal cancer who are not surgically resected or unwilling to undergo surgical resection. Although sex, age, primary tumor location, extrahepatic metastasis, the number of lesions and the extent of ablation have no effect on the prognosis of the patients, further prospective studies are needed.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735.34

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 徐東;李捷;郭文治;嚴(yán)鵬飛;陳三洋;張水軍;;高強(qiáng)度聚焦超聲治療原發(fā)性肝癌相關(guān)并發(fā)癥分析及處理[J];國(guó)際外科學(xué)雜志;2015年10期

2 朱小鵬;唐昃;周莉;;高強(qiáng)度聚焦超聲聯(lián)合化療治療結(jié)直腸癌肝轉(zhuǎn)移臨床研究[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2015年04期

3 楊揚(yáng);汪國(guó)營(yíng);;結(jié)直腸癌肝轉(zhuǎn)移的治療策略[J];中華肝臟外科手術(shù)學(xué)電子雜志;2015年01期

4 李鵬;王擁軍;陳光勇;許昌芹;;中國(guó)早期結(jié)直腸癌及癌前病變篩查與診治共識(shí)[J];中國(guó)醫(yī)刊;2015年02期

5 劉賢偉;周丁華;;高強(qiáng)度聚焦超聲在結(jié)直腸癌肝轉(zhuǎn)移治療中的臨床應(yīng)用[J];世界華人消化雜志;2014年06期

6 張衛(wèi)星;鐘瑜;彭碧玲;黃耀;鄧衛(wèi)萍;;高強(qiáng)度聚焦超聲聯(lián)合全身化療對(duì)結(jié)直腸癌肝轉(zhuǎn)移的近期療效[J];中國(guó)現(xiàn)代醫(yī)生;2013年32期

7 侯飛;;彩超檢查對(duì)原發(fā)性肝癌和繼發(fā)性肝癌的鑒別診斷[J];中國(guó)衛(wèi)生產(chǎn)業(yè);2012年28期

8 呂成;王正平;陸獻(xiàn)大;;射頻消融治療原發(fā)性與繼發(fā)性肝癌的臨床療效分析[J];醫(yī)學(xué)影像學(xué)雜志;2011年10期

9 黃松欽;梅昌武;陳舜英;江小瑩;;高強(qiáng)度聚焦超聲聯(lián)合化放療治療大腸癌肝轉(zhuǎn)移[J];中國(guó)腫瘤臨床與康復(fù);2011年01期

10 黃耀;張衛(wèi)星;彭淮都;魏楊輝;陳小珍;;高強(qiáng)度聚焦超聲對(duì)惡性腫瘤患者細(xì)胞免疫功能的影響[J];中國(guó)熱帶醫(yī)學(xué);2010年04期

，

本文編號(hào)：2146448