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超聲引導在 125I 放射性粒子植入治療近膈處肝癌中的安全性分析

目的 總結超聲引導下經皮 125I 放射性粒子組織間植入治療近膈處肝癌的臨床安全性及優勢。 方法 回顧性分析 2014 年 3 月至 2016 年 2 月期間于筆者所在醫院接受超聲引導下經皮 125I 放射性粒子植入治療的 10 例近膈處肝癌患者的臨床資料。 結果 10 例患者均按計劃行粒子植入，植入 125I 粒子 19～108 枚，平均植入 58.1 枚。植入過程順利，手術時間 30～90 min，平均 57 min。術后質量驗證示粒子分布滿意，無補種情況發生。2 例患者術后出現發熱，經抗炎及對癥治療后痊愈。1 例患者出現穿刺部位疼痛，給予止痛治療后好轉。10 例患者術后復查均未發現腹腔出血及積液，無血、氣胸等肺部并發癥發生，無膽汁漏、肝功能衰竭等嚴重并發癥發生。10 例患者均順利出院。術后 10 例患者均獲訪，隨訪時間為 6～43 個月，中位數為 18.5 個月。隨訪期間，2 例出現粒子移位，未出現嚴重后果，未予處理；未發現其他遠期并發癥發生。 結論 超聲引導下經皮 125I 放射性粒子植入治療近膈處肝癌的并發癥少，安全可靠，具有其優勢。

放射性碘-125 粒子植入治療腹腔腫瘤的徒手穿刺技巧

Radioactive Seeds Iodine-125 Implantation in Treatment of Advanced Colorectal Cancer: Report of Nine Cases

ObjectiveTo evaluate the viability, short-term clinical efficacy, and safety of ultrasound-guided radioactive seed 125I permanent implantation in tissue in patients with advanced colorectal cancer. MethodsA total of 9 patients were recruited in this study. All of the patients came from China-Japan Union Hospital of Jilin University from October 2012 to October 2014, which had been selected after strict screening. Five cases of male patients, 4 cases of female patients; the age was between 46-78 years old, the median age was 54 years old. There were 5 cases of patients with pain. There were 14 lesions in total, 1 lesion was local tumor recurrence, 2 lesions were pelvic metastasis, 8 lesions were liver metastases, and 3 lesions were abdominal lymph node metastasis. CEA increased in 6 cases before implantation. All patients were confirmed metastasis by CT, MRI examination or pathology. The 125I radioactive seed implantation was guided by real-time ultrasound. CT scanning was taken in two months after treatment. The degree of pain relief, tumor local control, and the occurrence of complications were observed. ResultsIn 2 months after implantation of 125I radioactive particles, the CT scanning results showed that 2 cases obtained complete response (CR), 5 cases obtained partial response (PR), 1 case got stable disease (SD), and 1 case got progress disease (PD). Total effective was 7/9, and disease control was 8/9. Five cases with pain symptoms were relieved after treatment. One walk metal particle in the abdominal cavity was found by abdominal CT scanning in 1 case. There were no serious complications intraoperative and postoperative. ConclusionsUltrasound guided radioactive seeds 125I implantation in the treatment of advanced colorectal cancer can significantly relieve the clinical symptoms, improve the quality of life, and can effectively control the metastasis. It is safe and feasible, and the postoperative hospitalization time is short, it has the avantages of safety, effectiveness, and low incidence of complications.

凝血機制異常致闌尾術后出血2例報道