摘要
目的 探讨CT引导下经皮穿刺植 入I125粒子治疗晚期肺纵膈肿瘤临床疗效 观察。方法 选取我院2013年2月-2016年 6月收治的晚期肺纵膈肿瘤患者70例, 按照入院治疗时间平均分为对照组和观 察组。对照组用常规化疗方案,观察组 患者用CT引导下经皮穿刺植入I125粒子 治疗,比较两组治疗疗效、病灶控制率 以及不良反应发生情况,从观察组CT引 导下经皮穿刺植入I125粒子治疗晚期肺纵 膈肿瘤分析其技术与疗效。结果 观察 组治疗60天、90天总有效率分别为27例 (77.14%)、33例(85.71%),在治疗后60 天与对照组总有效率相比,观察组优于 对照组(χ2=6.119,P=0.013<0.05),治 疗后90天有效率观察组较优(χ2=4.786, P=0.029<0.05),两组数据差异具有统 计学意义;观察组对3-5cm病灶控制率为 90.0%,优于对照组63.16%,具有统计学 意义(χ2=4.852,P=0.0.28<0.05);观察 组患者未发生出现粒子移动、丢失情况 以及其他重大并发症,对照组出现2例骨 髓抑制现象较为严重。CT可视下引导植 入粒子,准确率高,直观性好,对粒子 植入情况复查更为清晰明了。结论 CT引 导下经皮穿刺植入I125粒子治疗晚期肺纵 膈肿瘤对病灶控制能力高、疗效好且并 发症少,值得推广。
Objective To investigate the clinic effect of CT guided percutaneous I125 implantation in treating advanced stage lung mediastinum tumor. Methods 70 cases with advanced stage lung mediastinum tumor in our hospital from February 2013 to June 2016 were selected. Control group was given common treatment and observation group was given CT guided percutaneous I125 implantation. Compare the efficiency, focus control rate and adverse reactions of the patients. Analyze the technology and effect of CT guided percutaneous I125 implantation in treating advanced stage lung mediastinum tumor. Results Efficiency of observation group after 60, 90 d were 27 cases (77.14%), 33 cases (85.71%). 60d after treatment, total efficiency of observation group was better than control group (χ2 =6.119, P=0.013<0.05), 90d after treatment, observation group was better (χ2 =4.786, P=0.029<0.05), the difference was statistically significant; control rate of 3-5cm focus of observation group (90.0%) was better than control group (63.16%), the difference was statistically significant (χ2 =4.852, P=0.0.28<0.05). Particle migration, losing and other complications were not occurred in observation group, 2 cases of myelosuppression occurred in control group. CT guided percutaneous implantation had high accurate rate and better intuition. Conclusion CT guided percutaneous I125 implantation in treating advanced stage lung mediastinum tumor can control focus better, it has better effect and is worthy of wide application.
【关键词】CT引导下经皮穿刺;植入 I125粒子;晚期肺纵膈肿瘤
【中图分类号】R445.3;R734.5
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.03.023
前言
随着微创技术的发展,治疗方案更关切到患者的躯体感受,在治 疗的基础上降低患者痛苦为手术方案增加了难度[1]。对于晚期肺及纵 隔肿瘤传统放、化射治疗过程中,患者患者易发生抵制反应,这不仅 影响了患者治疗的最佳时间,且降低了患者预后生存时间,对患者的 心理有不可消除的负面情绪[2-3]。而CT引导下放射性粒子植入方案在针 对于肺及纵隔肿瘤,对于不能手术切除且化疗效果又不佳者,CT引导 下穿刺肿瘤植入碘125粒子内进行放疗是一个不错的选择[4-5]。为此, 本文进行了探讨。
中国CT和MRI杂志
第15卷, 第 3 期
2017年03月
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