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目的 探讨应用介入技术治疗晚期妇科癌的疗效、副作用与前景。方法 在 DSA下 ,采用 Seldinger s改良法 ,经皮行股动脉穿刺 ,选择髂动脉插管造影 ,向肿瘤供血动脉灌注化疗药物并 (或 )加明胶海绵栓塞。观察症状、体征及术后病理标本。结果 共介入治疗 9例病人。术前应用 3例 ,肿瘤体积缩小、松动 ,术后病理均见肿瘤细胞坏死。晚期肿瘤出血应用 3例 ,均短期内达到止血目的。 1例术后化疗、放疗后腹膜后淋巴结转移 ,经介入治疗临床症状完全缓解 ,CA1 2 5 明显下降。 1例子宫肉瘤伴肺转移 ,1例胎盘部位滋养叶细胞肿瘤 ,亦行介入治疗。结论 晚期妇科肿瘤病人术前应用介入治疗 ,可以使肿瘤细胞坏死 ,肿瘤体积缩小 ,使不能手术者得到手术机会 ;延长生存期 ,且明显缓解临床症状。对晚期肿瘤出血可作为应急的止血治疗 ,为晚期肿瘤术后复发者提供了治疗的机会。特别对淋巴结转移有意想不到的疗效。
Objective To investigate the efficacy, side effects and prospects of interventional technique in the treatment of advanced gynecological cancer. Methods Under DSA, modified Seldinger s method was used. Percutaneous femoral artery puncture and iliac arterial catheterization were performed. Chemotherapy was given to the tumor feeding artery and / or gelatin sponge embolization. Observe the symptoms, signs and postoperative pathological specimens. Results A total of 9 patients involved in the treatment. Preoperative application of 3 cases, the tumor size decreased, loosening, postoperative pathology showed tumor cell necrosis. 3 cases of advanced cancer bleeding, short-term to achieve the purpose of bleeding. One case of postoperative chemotherapy, retroperitoneal lymph node metastasis after radiotherapy, complete remission of clinical symptoms after interventional therapy, CA1 2 5 decreased significantly. One case of uterine sarcoma with lung metastases, one case of placental trophoblastic tumor cells, also interventional treatment. Conclusion The preoperative interventional treatment of advanced gynecological tumor patients can make the tumor cells necrosis and reduce the tumor volume, so that those who can not surgery have the chance of surgery; prolong the survival period and obviously relieve the clinical symptoms. For advanced hemorrhage can be used as an emergency hemostatic treatment for advanced postoperative tumor recurrence provided the opportunity for treatment. Especially for lymph node metastasis unexpected effect.