【摘要】：目的探討介入栓塞化療對不可切除膽囊癌的臨床療效。方法選取我院2012年3月至2017年3月收治的30例不可切除膽囊癌患者作為觀察對象。根據(jù)治療方式的不同,分為對照組和實驗組,其中對照組13例采用吉西他濱+奧沙利鉑的全身新輔助靜脈化療方案,實驗組17例全部采取經(jīng)肝動脈插管局部栓塞化療。觀察兩組病人的近期有效率、獲益率、腫瘤直徑有無變化和不良反應的差異。結(jié)果栓塞化療組近期臨床療效優(yōu)于新輔助化療組(P=0.0050.05),有效率高于新輔助化療組(P=0.0020.05),但介入栓塞化療組和新輔助化療組獲益率無顯著差異(P=0.0610.05)。兩組治療后腫瘤直徑均明顯縮小(P0.05),且介入栓塞化療組腫瘤直徑[(1.8±0.3)cm]小于新輔助化療組[(3.5±0.7)cm](P=0.0010.05)。兩組的發(fā)熱率、胃腸道反應發(fā)生率無明顯差異(P0.05),但介入栓塞化療組腹痛的發(fā)生率(83.4%)高于新輔助化療組(38.5%),骨髓抑制率(29.4%)低于新輔助化療組(76.9%)。兩組腹痛發(fā)生率、骨髓抑制發(fā)生率差異有統(tǒng)計學意義(P0.05)。結(jié)論栓塞化療和新輔助化療均對晚期膽囊癌有較好的近期療效,但相對于全身新輔助化療,介入栓塞化療近期療效更好,安全可行,值得臨床推廣。
[Abstract]:Objective to investigate the clinical effect of interventional chemoembolization on unresectable gallbladder carcinoma. Methods 30 patients with unresectable gallbladder carcinoma admitted in our hospital from March 2012 to March 2017 were selected as observation objects. According to the different treatment methods, the patients in the control group were divided into two groups: the control group (n = 13) was treated with gemcitabine oxaliplatin, and the control group (n = 17) was treated with transcatheter hepatic artery chemoembolization (TACE). The short-term effective rate, benefit rate, tumor diameter and adverse reactions were observed. Results the short-term clinical efficacy of embolization chemotherapy group was better than that of neo-adjuvant chemotherapy group (P0. 0050.05), and the effective rate was higher than that of neoadjuvant chemotherapy group (P0. 0020.05), but there was no significant difference between interventional chemoembolization group and neoadjuvant chemotherapy group (P0. 0610.05). The diameter of tumor decreased significantly in both groups after treatment (P0.05), and the diameter of tumor in interventional chemoembolization group [(1.8 鹵0.3) cm] was lower than that in neoadjuvant chemotherapy group [(3.5 鹵0.7) cm] (P0. 0010.05). There was no significant difference in the incidence of fever and gastrointestinal reaction between the two groups (P0.05), but the incidence of abdominal pain in the interventional chemoembolization group (83.4%) was higher than that in the neo-adjuvant chemotherapy group (38.5%), and the bone marrow inhibition rate (29.4%) was lower than that in the neo-adjuvant chemotherapy group (76.9%). The incidence of abdominal pain and bone marrow suppression were significantly different between the two groups (P0.05). Conclusion both chemoembolization and neoadjuvant chemotherapy are effective in the treatment of advanced gallbladder carcinoma, but compared with systemic neoadjuvant chemotherapy, interventional chemoembolization is more effective, safe and feasible, and worthy of clinical promotion.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.8

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