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中国现代手术学杂志  2018, Vol. 22 Issue (1): 56-60    DOI: 10.16260/j.cnki.1009-2188.2018.01.015
  临床论著 |
中晚期宫颈癌动脉灌注化疗临床疗效分析
潘静,姚丽艳,朱晓玉,孙业亮
新疆医科大学第二附属医院妇产科,乌鲁木齐 830028
The Clinical Effect Analysis on Bilateral Internal Iliac Arterial Infusion Chemotherapy for AdvancedCervical Carcinoma
PAN Jing,YAO LI-yan,ZHU Xiao-yu,SUN Ye-liang
Department?of?Obstetrics?and?Gynecology,The?Second?Affiliated?Hospital?of?Xingjiang?Medical?University,Urumqi?830028,Xinjiang,China
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摘要 目的?探讨动脉灌注化疗在中、晚期宫颈癌患者治疗中的临床疗效。方法?回顾性分析2008年1月~2013年12月我科治疗的47例Ⅱb~Ⅲb期宫颈癌患者的临床资料,按FIGO分期:Ⅱb期36例,Ⅲa期1例,Ⅲb期10例;其中鳞状细胞癌46例,腺癌1例;病理分级:低分化8例,中分化21例,高分化18例。均行双侧髂内动脉灌注化疗,其中22例化疗后行广泛子宫切除+盆腔淋巴结清扫术。观察临床疗效、化疗后手术率、化疗前后患者的骨髓抑制、肝肾功能损害及其他并发症。结果?47例患者临床有效率为76.6%,化疗后手术率为46.8%。Ⅱb期患者临床有效率高于Ⅲ期患者,差异有统计学意义(χ2=12.241,P=0.001)。Ⅱb期患者手术率明显高于Ⅲa、Ⅲb期患者 (χ2=15.032,χ2=13.843,P均<0.01)。宫颈癌患者肿瘤组织学分化程度与临床化疗缓解率无相关性 (r=0.012,P=0.081);临床分期与临床化疗缓解率呈正相关(r=0.585,P=0.000)。化疗后患者白细胞(WBC)、血小板(PLT)较化疗前降低,丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转氨酶(AST)、肌酐值(Cr)及尿胆原(Ur)较化疗前升高(P<0.05)。均未发生严重不良反应。结论?动脉灌注化疗对中晚期宫颈癌患者有较好的临床疗效及手术率,不良反应少,是一种有效的治疗方法。
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潘静,姚丽艳,朱晓玉,孙业亮
关键词:  宫颈癌  化学疗法,肿瘤,局部灌注    
Abstract: Objective?To investigate the clinical effect of bilateral internal iliac arterial infusion chemotherapy for treatment of advanced cervical carcinoma.Methods?The clinicaldata of 47 cervical carcinoma cases were reviewed,including 36 of Ⅱb,1of Ⅲa and 10 of Ⅲb according to FIGO staging.There were 46 cases of squamous-celled carcinoma and 1case of adenocarcinoma.The pathological exam revealed poorlydifferentiated in 8 cases,moderatelydifferentiated in 21cases and welldifferentiated in 18 cases.Bilateral internal iliac arterial infusion chemotherapy was performed in all 47 cases,and radicalhysterectomy and pelvic lymph nodedissection was carried out in 22 cases after chemotherapy.The short-term clinical effect,operation rate were observed.The bone marrow suppression and liver and kidney functiondamage were observed before and after chemotherapy.Results?The total remission rate was 76.6%,and the operative rate after chemotherapy was 46.8%.The effective rate washigher in stage Ⅱb than that in stage Ⅲ (χ2=12.241,P=0.001),and the operative rate of stage Ⅱb patients was significantlyhigher than that of stage Ⅲa and Ⅲb patients (χ2=15.032,χ2=13.843,P<0.01).No correlation was found between tumorhistologicaldifferentiation and clinical chemotherapy remission rate in cervical cancer patients (r=0.012,P=0.081).There was a positive correlation between clinical stage and clinical chemotherapy remission rate (r=0.585,P=0.000).The leukocyte (WBC) and platelet (PLT) weredecrease,while alanine aminotransferase (ALT),aspartate aminotransferase (AST),urobilinogen(Ur) and creatinine (Cr) were increased after the chemotherapy (P<0.05).There was no serious adverse reaction after the operation.Conclusion?The bilateral internal iliac arterial infusion chemotherapy can achieve a better clinical effect,high operation rate and less adverse reaction for advanced cervical carcinoma patients,and it is a kind of effective comprehensive therapy.
Key words:  cervical carcinoma    chemotherapy,cancer,regional perfusion
                    发布日期:  2018-08-13      期的出版日期:  2018-08-13
ZTFLH:  R737.33  
基金资助: 新疆维吾尔自治区自然科学基金(2017D01C241)
通讯作者:  姚丽艳,女,54岁,新疆医科大学第二附属医院妇产科主任医师,教授。   
作者简介:  潘静,女,36岁,新疆医科大学第二附属医院妇产科主治医师。
引用本文:    
潘静,姚丽艳,朱晓玉,孙业亮. 中晚期宫颈癌动脉灌注化疗临床疗效分析[J]. 中国现代手术学杂志, 2018, 22(1): 56-60.
PAN Jing. The Clinical Effect Analysis on Bilateral Internal Iliac Arterial Infusion Chemotherapy for AdvancedCervical Carcinoma. Chinese Journal of Modern Operative Surgery, 2018, 22(1): 56-60.
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