【摘要】 目的探讨碘-125粒子组织间永久性植入在晚期胰头及胆管恶性肿瘤治疗中的效果及方法。方法收集我院腹部外科2013.5~2013.12间13例失去手术机会的恶性梗阻性黄疸病人的资料,并进行疗效分析及方法探讨。结果全部13名患者均经ERCP置放胆道支架成功后接受组织间碘125粒子的放射治疗。其中4例在CT引导下经皮穿刺置放,9例经小切口开腹直视下穿刺植入,所有病例均无出血、胰瘘、胆漏、腹腔感染等并发症发生。术后一个月胆红素、转氨酶及肿瘤指标均明显降低。术后1、3、6、9个月进行疗效评估,其中4例部分缓解,7例疾病稳定,2例疾病进展。所有病人均无胆道再阻塞发生(其中1例术后3个月更换为鼻胆管引流)。所有13例病人均随访,11例存活至今(2014.8.25)。1例肝门部胆管癌、1例胰头癌患者因转移病灶进展于术后6个月、8个月死亡。结论经ERCP胆道支架置人术联合碘125粒子是一种崭新的治疗手段,结合了内镜与放疗的特点,充分发挥了二者的优势,治疗效果满意。本组病例短期内疗效明显,长期疗效尚有待进一步观察。更多还原

【Abstract】 Objective To investigate the effect and mode of radioactive I125 seed implantation in the advanced cancer of pancreas and bile duct. Methods The clinical data of 13 cases with advanced pancreatic carcinoma or bile duct carcinoma at the An Hui Provincial Tumor Hospital from May. 2013 to Dec. 2013 were analyzed. Results All of the 13 cases were implanted the radioactive I125 seed before they placed biliary tract prosthesis. 4 of them were implanted under the guidance of CT,9 of them were implanted under the operation. There was no complication happened. The bilirubin,ALT and tumor marker were reduced obviously after one month. No case was observed the bile duct obstruction from the operation day to now( 25 /8 /2014). Conclusion It is a new way to treat the jaundice obstructive by radioactive I125 seed implantation combined with ERCP. It takes full advantage of the endoscope and radiotherapy.更多还原